Laparoscopic Roux-en-Y gastric bypass in morbidly obese and super morbidly obese patients

• Published in: The American journal of surgery 2004-02, Vol.187 (2), p.230-232
• Main Authors: Dresel, Alexandra, Kuhn, Joseph A, McCarty, Todd M
• Format: Article
• Language: English
• Subjects: Adult; Anastomosis, Roux-en-Y; Biological and medical sciences; Blood transfusions; Body mass index; Embolisms; Female; Gastric bypass; Gastric Bypass - methods; Gastrointestinal surgery; General aspects; Hernias; Humans; Laparoscopy; Laparoscopy - methods; Male; Medical sciences; Metabolic diseases; Middle Aged; Obesity; Obesity, Morbid - surgery; Postoperative Complications; Postoperative period; Prospective Studies; Super morbid obesity; Teaching hospitals; Treatment Outcome; Weight control
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2003.08.017

Our objective was to compare the outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB) in morbidly obese (body mass index [BMI] 50) patients. A prospective analysis of 120 patients who underwent laparoscopic RYGB at a community based teaching hospital between January 2002 and August 2002 was performed. Sixty patients with BMI 50. Study endpoints included: operative time, length of stay, and overall complication rates including early (7 days) complications. Mean BMI in the obese group was 44.6 (range 39 to 49) versus 58.6 (range 50 to 100) in the superobese group. Medical comorbidities, age, and sex distribution were similar in both groups. Mean operative time in the obese group was 128 minutes (range 75 to 225) versus 144 minutes (range 75 to 240) in the superobese group. The overall complication rate was 10% in the obese group versus 20% in the superobese group. ( P = 0.2) With regard to the obese group, the early complication rate was 5% (n = 3). These included 2 upper gastrointestinal bleeds and 1 respiratory failure. The late complication rate in this group was also 5% (n = 3). These were all anastomotic strictures requiring endoscopic dilation. In comparison, in the superobese group, the early complication rate was 8% (n = 5). These included 2 upper gastrointestinal bleeds, 1 pneumonia, 1 superficial wound infection, and 1 small bowel obstruction. The late complication rate in this group was 12% (n = 7). These included 4 anastomotic strictures, 1 incisional hernia, 1 pulmonary embolism, and 1 anastomotic leak. There were no conversions to open gastric bypass or deaths in either group. Median length of stay in both groups was 2 days. Our data demonstrate no significant difference in operative times, complication rates or length of stay between morbidly obese and super morbidly obese patients undergoing laparoscopic RYGB. Laparoscopic RYGB is safe and technically feasible in the super morbidly obese patient population.