Laparoscopic silastic ring mini-gastric bypass: a single centre experience.

Abstract

BACKGROUND:

Laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to Roux-en-Y gastric bypass. The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports on the results of a consecutive cohort of patients undergoing SR-MGBP in a single centre.

METHODS:

Short- and medium-term outcomes of 156 consecutive patients undergoing surgery between August 2005 and January 2008 were analysed. Weight loss, comorbidity resolution and morbidity/mortality were assessed.

RESULTS:

A total of 156 patients (78% female, 22% male) with a mean (range) age of 44 years (18-63), pre-operative weight of 129 kg (83-197) and body mass index of 46 kg/m(2) (35-64) underwent surgery. Eighty-seven percent had pre-operative comorbidities, and median (range) follow-up was 35 months (6-72). Mean (SD) % excess weight loss (EWL) at 6, 12, 24, 36 and 60 months was 74.6 (19.5), 93.4 (21.1), 98.8 (27.6), 93.5 (20.1) and 89 (16.1) respectively. Thirty-seven percent had complete resolution of comorbidities and 67.3% required vitamin/mineral supplementation. Overall, 10.3% patients suffered early complications, of which 7.7% were minor and 2.6% were major. A total of 45.5% patients suffered late complications, of which 34.6% were minor and 10.9% were major. Food intolerance/vomiting, bile reflux and stomal ulcer were seen in 18.6, 10.3 and 7.7% of patients, respectively. Surgical re-intervention was required in 12.8% of patients. There were no deaths.

CONCLUSIONS:

Whilst SR-MGBP achieves excellent EWL with low mortality, there is a high incidence of food intolerance/vomiting likely related to the silastic ring. The majority of complications were managed with pharmacological and endoscopic intervention, although 13% required reoperation within 5 years.

• Authors: M G Clarke, K Wong, L Pearless, M Booth
• Journal: Obesity surgery (Obes Surg) Vol. 23 Issue 11 Pg. 1852-7 (Nov 2013) ISSN: 1708-0428 [Electronic] United States
• PMID: 23836041 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Dimethylpolysiloxanes
• baysilon

Topics

• Adult
• Bile Reflux (etiology)
• Body Mass Index
• Dimethylpolysiloxanes
• Equipment Design
• Female
• Follow-Up Studies
• Gastroplasty (adverse effects, methods)
• Humans
• Laparoscopy (methods)
• Length of Stay (statistics & numerical data)
• Male
• Middle Aged
• New Zealand (epidemiology)
• Obesity, Morbid (epidemiology, surgery)
• Patient Selection
• Treatment Outcome
• Vomiting (epidemiology, etiology)
• Weight Loss