Page 26 - WALS Journal

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Review of Various Aspects of Laparoscopic Roux-en-Y Gastric Bypass to Emphasize its Significance in Bariatric Surgery

Retrospective study of 400 consecutive RYGB patients 7. Hagen J, Deitel M, Khanna RK, Ilves R. Gastroesophageal reflux
(1999-2002) supports that, enteric leakage is an important in the morbidly obese. Int Surg 1987;72:1-3.
complication of the RYGB. Leaks that are more insidious 8. Benotti PN, Forse RA. The role of gastic surgery in the multi-
disciplinary management of severe obesity. Am J Surg 1995;169:
can be treated successfully with percutaneous drainage. 28 361-67.
Leak after LRYGB may be difficult to detect. Evidence of 9. Nguyen NT, Root J, Zainabadi K, Sabio A, Chalifoux S,
respiratory distress and tachycardia exceeding 120 beats Stevens CM, et al. Accelerated growth of bariatric surgery with
per minute may be the most useful clinical indicators of the introduction of minimally invasive surgery. Arch Surg
2005;140:1198-202.
leak after LRYGP. 29 10. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric
Comeau et al (2003) documented 35 cases of internal bypass, Roux-en-Y: Preliminary report of five cases. Obes Surg
hernia (overall incidence of 3.3%). The IH occurred in 6.0% 1994;4:353-57.
of patients with retrocolic procedures and 3.3% of patients 11. Saber AA, Elgamal MH, McLeod MK. Bariatric surgery: The
with antecolic procedures. Most were in the Petersen defect past, present and future. Obes Surg 2008 Jan;18(1):121-28.
(55.9%) and at the enteroenterostomy site (35.3%). 12. Brolin RE, Robertson LB, Kenler HA, et al. Weight loss and
dietary intake after vertical banded gasytroplasty and Roux-
A bimodal presentation was observed, with 22.9% of en-Y gastric bypass. Ann Surg 1994;220:782-90.
patients with IH diagnosed in the early postoperative period 13. Bowne WB, Julliard K, Castro AE, Shah P, Morgenthal CB,
(2-58 days) and 77.1% in a delayed fashion (187-1, Ferzli GS. Laparoscopic gastric bypass is superior to adjustable
109 days). A laparoscopic approach to the repair of IH was gastric band in super morbidly obese patients. A prospective,
comparative analysis. Arch Surg 2006;141:683-89.
possible in 60.0% of patients. Complications occurred in 14. Schirner B. Laparoscopic bariatric surgery. Surg Endosc 2006
18.8% of patients, including one death (2.9%). 30 Apr;(20 Supple)2:545-55.
15. Kreitz K, Rovito PF. Laparoscopic Roux-en-Y gastric bypass
CONCLUSION is safe and effective in patients with a BMI of 70 or greater.
Laparoscopic Roux-en-Y Gastric Bypass in the Megaobese.
The selection of surgical technique for a particular patient Arch Surg 2003;138:707-09.
must be decided by a surgeon who has all of the tools 16. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric
accessible to him in his surroundings. Decisions should be bypass, Roux-en-Y: Technique and results in 75 patients with
made depending on the individual clinical scenario. No 3 to 30 months follow-up. Obes Surg 1996;6:500-04.
single tool or procedure can be considered suitable for all 17. Nguyen NT, Ho HS, Palmer LS, Wolfe BM. Laparoscopic Roux-
en-Y gastric bypass for super/super obesity. Obes Surg 1999;9:
patients. Assimilation of all the known data is essential for 403-06.
the surgeon to offer the correct procedure to the correct 18. Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-
patient. The well-informed and well-trained individual will en-Y gastric bypass for morbid obesity. Technique and
recognize that the best preference for most patients looking preliminary results of our first 400 patients. Arch Surg 2000;135:
for surgical treatment of clinical severe obesity is RYGBP. 1029-33.
19. Van Dessel E, Hubens G, Ruppert M, Balliu L, Weyler J,
Vaneerdeweg W. Roux-en-Y gastric bypass as a redo procedure
REFERENCES for failed restrictive gastric surgery. Surg Endosc 2008 Apr;

1. Kuczmarski RJ, Flegal KM, Campbell SM, Johnson CL. 22(4):1014-18.
Increasing prevalence of overweight among US adults. The 20. Cummings DE, Weigle DS, Frayo RS. Plasma ghrelin levels
national health and nutrition examination surveys, 1960 to 1990. after diet-induced weight loss or gastric by-pass surgery. N Engl
JAMA 1994;272:205-11. J Med 2002;346:1623-30.
2. Sjostrom CD, Lissner L, Wedel H, Sjostrom L. Reduction in 21. Torquati A, MSCI, Lutfi R, Abumrad N, Richards WO. Is Roux-
incidence of diabetes, hypertension and lipid disturbance after en-Y gastric bypass surgery the most effective treatment for
intentional weight loss induced by bariatric surgery: The SOS type 2 diabetes mellitus in morbidly obese patients? J Gastro-
intervention study. Obes Res 1999;7:477-84. intest Surg 2005;9(8):1112-18.
3. Fried M, Peskova M, Kasalicky M. Bariatric surgery in some 22. Meneghini FR. Impact of bariatric surgery on type 2 diabetes.
central and East-European (formerly Eastern block) countries— Cell Biochem Biophys 2007 Jul;48(2-3);97-102.
current status and prediction for the next millennium. Obes Surg 23. Ballesta-Lopez C, Poves I, Cabrera M, Almeida JA. Learning
2000;10:255-58. curve for laparoscopic Roux-en-Y gastric bypass with totally
4. Gopalan C. Obesity in the urban middle class. NFI Bulletin hand-sewn anastomosis: Analysis of first 600 consecutive
1998;19:1-4. patients. Surg Endosc 2005 Apr;19(4):519-24.
5. Gopinath N, Chadha SL, Jain P, Shekhawat S, Tandon R. An 24. Papasavas PK, Hayetian FD, Caushaj PF, Landreneau RJ,
epidemiological study of obesity in adults in the urban population Maurer J, Keenan RJ, et al. Outcome analysis of laparoscopic
of Delhi. J Assoc Physicians India 1994;42:212-15. Roux-en-Y gastric bypass for morbid obesity. The first 116
6. Bauchwold H, Consensus Conference Parell, bariatric sugery cases. Surg Endosc 2002 Dec;16(12);1653-57.
for morbid obesity: Health implications for patients, health 25. Muhlmann, et al. DaVinci robotic-assisted laparoscopic bariatric
professionals and third party payers. J Am Coll Surg 2005; surgery: Is it justified in a routine setting? Obes Surg 2003;13(6):
200:593-604. 848-54.
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