Page 23 - WALS Journal

10.5005/jp-journals-10033-1162
Danish Javed
REVIEW ARTICLE
Review of Various Aspects of Laparoscopic Roux-en-Y

Gastric Bypass to Emphasize its Significance in

Bariatric Surgery

Danish Javed

ABSTRACT States, a 144% increase in the number of American Society
for Bariatric Surgery bariatric surgeons, and a 146% increase
Obesity is a form of malnutrition and it has been growing globally.
Surgical management of morbid obesity is increasing in in the number of bariatric centers. The growth of
response to its epidemic rise. The growth of laparoscopic laparoscopic bariatric surgery during this 5-year period
bariatric surgery greatly exceeds that of open bariatric surgery. greatly exceeds that of open bariatric surgery. National
9
The aim of this study is to review the various aspect of the
laparoscopic Roux-en-Y Gastric Bypass (LRYGBP) to Institutes of Health Consensus (NIH) Conference convened
emphasize its significance in Bariatric Surgery. Laparoscopic in 1991, specifically identified Roux-en-Y gastric bypass
Roux-en-Y gastric bypass is a well-structured and well- (RGB) and vertical banded gastroplasty (VBG) as surgical
understood operation that is valuable for the treatment of
rigorous obesity. The laparoscopic Roux-en-Y gastric bypass options that provide significant benefits for patients with
has been shown to be safe and effective. The individual will clinical severe obesity. In 1994, Wittgrove, Clark and
recognize that the best preference for most patients looking for Tremblay performed the first laparoscopic RYGB
surgical treatment of clinical severe obesity is laparoscopic
RYGBP. (LRYGB), which at the time was considered a technical
tour de force. 10
Keywords: Morbid obesity, Laparoscopy bariatric surgery,
Roux-en-y, Comparison obesity surgery, Open laparoscopy There are following different options available in
bariatric, Complication Roux-en-Y. bariatric surgery. 11
• Purely malabsorptive procedures
How to cite this article: Javed D. Review of Various Aspects
of Laparoscopic Roux-en-Y Gastric Bypass to Emphasize its – Jejunoileostomy
Significance in Bariatric Surgery. World J Lap Surg 2012;5(3): – Biliopancreatic diversion
116-120. • Combined malabsorptive and restrictive procedures
Source of support: Nil – Duodenal switch
– Gastric bypass
Conflict of interest: None declared
– Digestive adaptation
INTRODUCTION • Restrictive procedures
– Gastroplasty
Obesity is the commonest form of malnutrition and it has – Gastric banding
been increasing over the last few decades globally. 1-3 – Sleeve gastrectomy
In India up to 50% of women and 32.2% of men in the – Gastric pacing
upper socioeconomic class come under the obese category. • Robotic surgery
In Delhi, the prevalence of obesity is 33.4% in women and • Endoluminal bariatric surgery
4,5
21.3% in men. According to Framingham data for each • Restrictive endoluminal procedures
pound weight gained between ages 30 and 42 years, there • Malabsorptive endoluminal procedures.
is 1% increased mortality within 26 years, and for each
pound gained after that, it is the 2% increased mortality. In AIM
morbid obese, average life expectancy is reduced by 12 years
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in men and 9 years in women. Type 2 diabetes, The aim of this study is to review the various aspect of the
hypertension, hyperlipidemia, stroke, atherosclerosis, LRYGB to emphasize its significance in bariatric surgery.
osteoarthritis, hypoventilation, sleep apnea syndrome, MATERIALS AND METHODS
GERD, infertility and urinary stress incontinence in females,
certain cancers (endometrium, colon, breast, prostate) and A thorough literature and clinical search was performed.
7
sudden death are comorbidities. Surgical management of The following search terms was used: Morbid obesity,
morbid obesity is increasing in response to its epidemic rise. 8 laparoscopy bariatric surgery, Roux-en-Y, comparison
Between 1998 and 2002, there was a 450% increase in the obesity surgery, open laparoscopy bariatric, complication
number of bariatric operations performed in the United Roux-en-Y.
116
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