Outcomes After Laparoscopic Roux-en-Y Gastric Bypass for... : Annals of Surgery (original) (raw)

Scientific Papers

Schauer, Philip R. MD; Ikramuddin, Sayeed MD; Gourash, William CRNP; Ramanathan, Ramesh MD; Luketich, James MD

From the Department of Surgery, University of Pittsburgh, and the Mark Ravitch/Leon Hirsch Center for Minimally Invasive Surgery, Pittsburgh, Pennsylvania

Correspondence: Philip R. Schauer, MD, Dept. of Surgery, University of Pittsburgh, Presbyterian University Hospital, C-800, 200 Lothrop St., Pittsburgh, PA 15213-2582.

Presented at the 120th Annual Meeting of the American Surgical Association, April 6–8, 2000, The Marriott Hotel, Philadelphia, Pennsylvania.

E-mail: [email protected]

Accepted for publication April 2000.

Abstract

Objective

To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months.

Summary Background Data

The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative complications. A laparoscopic approach has significant potential to reduce perioperative complications and recovery time.

Methods

Consecutive patients (n = 275) who met NIH criteria for bariatric surgery were offered laparoscopic Roux-en-Y gastric bypass between July 1997 and March 2000. A 15-mL gastric pouch and a 75-cm Roux limb (150 cm for superobese) was created using five or six trocar incisions.

Results

The conversion rate to open gastric bypass was 1%. The start of an oral diet began a mean of 1.58 days after surgery, with a median hospital stay of 2 days and return to work at 21 days. The incidence of early major and minor complications was 3.3% and 27%, respectively. One death occurred related to a pulmonary embolus (0.4%). The hernia rate was 0.7%, and wound infections requiring outpatient drainage only were uncommon (5%). Excess weight loss at 24 and 30 months was 83% and 77%, respectively. In patients with more than 1 year of follow-up, most of the comorbidities were improved or resolved, and 95% reported significant improvement in quality of life.

Conclusion

Laparoscopic Roux-en-Y gastric bypass is effective in achieving weight loss and in improving comorbidities and quality of life while reducing recovery time and perioperative complications.