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Laparoscopic Silastic Ring Mini-Gastric Bypass (SR-MGBP): Up to 11-Year Results from a Single Centre

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Abstract

Background

Bariatric surgery is well established as an effective method for treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports long-term results from a cohort of patients undergoing a SR-MGBP in a single centre.

Methods

Long-term outcomes (up to 11 years) in a cohort of 156 patients undergoing surgery between August 2005 and January 2008 were analysed. A combination of follow-up questionnaires and electronic hospital records were used to assess weight loss, comorbidity resolution and complications.

Results

A total of 156 patients (mean body mass index 46 kg/m2) underwent surgery. Ninety-two patients responded to the follow-up questionnaires. Computer-based hospital information was available on a total of 139 patients. Mean percent excess weight loss (%EWL) at 11 years was 84.3%. Comorbidity resolution, determined by medication use, showed a reduction in diabetes (21.8% to 7.1%), hypertension (37.2% to 21.4%) and hypercholesterolaemia (40.4% to 13.4%). Five of 139 patients (3.6%) had SR problems needing removal. Two other patients had the SR changed to a bigger size and a further two had endoscopic removal of the SR for erosion. Of the 139 patients, 9.4% required conversion to a Roux-en-Y gastric bypass (RYGBP). The number of patients on anti-reflux medications increased from 5.1% to 44.6% at 11 years. There were two deaths unrelated to surgery.

Conclusions

SR-MGBP appears to be a safe and effective operation for the morbidly obese. It is durable, with good weight loss at up to 11 years post-surgery. The SR can easily be removed or exchanged for another size and is reasonable to consider when performing a MGBP. Concerns about bile reflux appear to be well founded, and some patients who are poorly controlled medically will require revision.

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Authors and Affiliations

  1. Department of Surgery North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland, New Zealand

    Laila Sheikh & Michael WC Booth

  2. Waitemata Specialist Centre, 13-15 Shea terrace, Takapuna, Auckland, New Zealand

    Lyn A. Pearless & Michael WC Booth

Authors
  1. Laila Sheikh
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  2. Lyn A. Pearless
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  3. Michael WC Booth
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Corresponding author

Correspondence to Laila Sheikh.

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Conflict of Interest

Dr. Sheikh has nothing to disclose.

L. Pearless MN (Hons) has nothing to disclose.

Dr. Booth has nothing to disclose.

Informed Consent

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

Statement of Human and Animal Rights

The study has been approved by the national ethics committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Sheikh, L., Pearless, L.A. & Booth, M.W. Laparoscopic Silastic Ring Mini-Gastric Bypass (SR-MGBP): Up to 11-Year Results from a Single Centre. OBES SURG 27, 2229–2234 (2017). https://doi.org/10.1007/s11695-017-2659-9

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  • DOI: https://doi.org/10.1007/s11695-017-2659-9

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