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Laparoscopic Magenstrasse and Mill Gastroplasty. First Results of a Prospective Study

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Abstract

Background

The Magenstrasse and Mill (M&M) procedure is a vertical gastroplasty creating a tubular pouch extending from the cardia to the antrum. This “incomplete sleeve” avoids gastric resection or band placement. In this paper, we report our experience of the laparoscopic approach of the technique in a selected obese population excluding prominent grazer and/or sweet eaters.

Material and Methods

One hundred patients (39 males, 61 females) underwent the procedure in a prospective trial. Mean age was 40 years (range 18–68). Mean preoperative BMI was 43.2 kg/m2 (range 35–62).

Results

The procedure was performed by laparoscopy starting with the creation of a circular opening at the junction of antrum and corpus followed by a vertical stapling to the angle of Hiss. Mean duration of the procedure was 67 (range 40–122) min. No intraoperative complication occurred. Mean hospital stay (SD) was 2.5 (0.9) days. The single postoperative complication consisted in a mild stenosis that responded to endoscopic dilatation. After a mean follow-up of 15 months (range 9–24), mean percentage of excess body weight loss (SD) was 48(14), 59(18) and 68(24)%, respectively at 3, 6, and 12 months. Quality of life appeared satisfactory with a low incidence of gastroesophageal reflux. The procedure was associated with improvement or resolution of diabetes, arterial hypertension, and dyslipemia at 1 year.

Conclusions

Our experience demonstrated that the M&M procedure could be performed safely laparoscopically. The satisfactory results on weight loss, obesity-associated mordities, and quality of life will need to be confirmed on longer follow-up.

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Acknowledgments

The authors are thankful to Claire Bodeson for her efficiency as coordinator and database manager.

Conflict of Interest

Arnaud De Roover: no conflict of interest.

Laurent Kohnen: no conflict of interest.

Jenny Deflines: no conflict of interest.

Barbara Lembo: no conflict of interest.

Vinciane Goessens: no conflict of interest.

Nicolas Paquot: no conflict of interest.

Severine Lauwick: no conflict of interest.

Abdourhamane Kaba: no conflict of interest.

Jean Joris: no conflict of interest.

Michel Meurisse: no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Abdominal Surgery and Transplantation, Centre Hospitalier Universitaire de Liège, ULg, Domaine du Sart Tilman, 4000, Liège, Belgium

    Arnaud De Roover, Laurent Kohnen & Michel Meurisse

  2. Department of Diabetology, Centre Hospitalier Universitaire de Liège, ULg, Domaine du Sart Tilman, 4000, Liège, Belgium

    Jenny Deflines & Nicolas Paquot

  3. Department of Dietetics, Centre Hospitalier Universitaire de Liège, ULg, Domaine du Sart Tilman, 4000, Liège, Belgium

    Vinciane Goessens

  4. Department of Psychology, Centre Hospitalier Universitaire de Liège, ULg, Domaine du Sart Tilman, 4000, Liège, Belgium

    Barbara Lembo

  5. Department of Anesthesiology, Centre Hospitalier Universitaire de Liège, ULg, Domaine du Sart Tilman, 4000, Liège, Belgium

    Severine Lauwick, Abdourhamane Kaba & Jean Joris

Authors
  1. Arnaud De Roover
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  2. Laurent Kohnen
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Correspondence to Arnaud De Roover.

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De Roover, A., Kohnen, L., Deflines, J. et al. Laparoscopic Magenstrasse and Mill Gastroplasty. First Results of a Prospective Study. OBES SURG 25, 234–241 (2015). https://doi.org/10.1007/s11695-014-1424-6

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  • DOI: https://doi.org/10.1007/s11695-014-1424-6

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