Abstract
The laparoscopic gastric bypass was once considered to be one of the most challenging minimally invasive operations. It is now the most common foregut operation and, despite its complexity and learning curve, has been shown to be safer and more cost-effective than its open predecessor. The operation has evolved to include a variety of anastomotic techniques and trocar placements, giving individual surgeons the latitude to adopt or modify the procedure based on their own preference and experience.
This chapter will discuss the basic construct and operative techniques in use today; there is no one method that is the “gold standard.” Comparative studies are few, and those that exist only reinforce that there are subtleties to operative technique that defy observation. For example, gastrojejunal stricture rate may be influenced more by preservation of blood supply and operative technique rather than the diameter of the circular stapler. It would be naïve to expect every surgeon to achieve the same results, given the same basic technique; it is up to each individual to modify, adapt, and improve through his or her own experience.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4:4353–7.
Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47:1345–51.
Evans S, Pamuklar Z, Rosko J, Mahaney P, Jiang N, Park C, Torquati A. Gastric bypass surgery restores meal stimulation of the anorexigenic gut hormones glucagon-like peptide-1 and peptide YY independently of caloric restriction. Surg Endosc. 2012;26(4):1086–94.
Hatoum IJ, Greenawalt DM, Cotsapas C, Reitman ML, Daly MJ, Kaplan LM. Heritability of the weight loss response to gastric bypass surgery. J Clin Endocrinol Metab. 2011;96(10):1630–3.
De la Torre RA, Scott JS. Laparoscopic Roux-en-Y gastric bypass: a totally intra-abdominal approach—technique and preliminary report. Obes Surg. 1999;9:101–6.
Williams MD, Champion JK. Linear technique of laparoscopic Roux-en-Y gastric bypass. Surg Technol Int. 2004;13:101–5.
Iannelli A, Facchiano E, Gugenheim J. Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Obes Surg. 2006;16:1265–71.
Jones K. Experience with the Roux-en-Y gastric bypass, and commentary on current trends. Obes Surg. 2000;10:183–5.
Pories W, Swanson M, MacDonald K. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.
Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003;237:751–8.
Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244:734–40.
Higa KD, Ho T, Tercero F, Yunus T, Boone KB. Laparoscopic Roux-en-Y gastric bypass: 10-year follow-up. Surg Obes Relat Dis. 2011;7:516–25.
Himpens J, Verbrugghe A, Cadiėre G, Everaerts W, Greve J. Long-term results of laparoscopic Roux-en-Y gastric bypass: evaluation after 9 years. Obes Surg. 2012;22:1586–93.
Adams T, Davidson L, Litwin S, Kolotkin RL, LaMonte MJ, Pendleton RC, et al. Health benefits of gastric bypass surgery after 6 years. JAMA. 2012;11:1122–31.
Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.
Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Swedish Obese Subjects Study, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.
Suter M, Donadini A, Romy S, Demartines N, Giusti V. Laparoscopic Roux-en-Y gastric bypass: significant long-term weight loss, improvement of obesity-related comorbidities and quality of life. Ann Surg. 2011;254(2):267–73.
Buchwald H, Estok R, Fahrbach K, Banel D, Sledge I. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;4:621–32.
Podnos YD, Jimenez JC, Wilson SE, Stevens CM, Nguyen NT. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg. 2003;138(9):957–61.
King WC, Chen JY, Mitchell JE, Kalarchian MA, Steffen KJ, Engel SG, et al. Prevalence of alcohol use disorders before and after bariatric surgery. JAMA. 2012;307(23):2516–25.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer Science+Business Media New York
About this chapter
Cite this chapter
Higa, K.D. (2015). Laparoscopic Gastric Bypass: Technique and Outcomes. In: Nguyen, N., Blackstone, R., Morton, J., Ponce, J., Rosenthal, R. (eds) The ASMBS Textbook of Bariatric Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1206-3_15
Download citation
DOI: https://doi.org/10.1007/978-1-4939-1206-3_15
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4939-1205-6
Online ISBN: 978-1-4939-1206-3
eBook Packages: MedicineMedicine (R0)