MEMPHIS-Add gastric bypass for morbid obesity to laparoscopy’s growing list of accomplishments.
In several recent studies, surgeons report that minimally invasive proximal Roux-en-Y gastric bypass can be done safely and effectively for obese patients, though not for those with a BMI much over 50 kg/m2.
In a Medical College of Virginia prospective study comparing 61 laparoscopic patients (mean 282 pounds) with 89 similar patients having open surgery, laparoscopy did not increase adverse outcomes such as mortality or anastomotic leaks. A major advantage was a 3% rate of incisional hernias, vs. 18% for open surgery, and no major wound infections, vs. 8% for the open procedure, Dr. Eric DeMaria’s team told the American Society for Bariatric Surgery meeting here.
At one year, mean weight loss of around 100 pounds was essentially the same in both groups. The average hospital stay was 3.2 days in the laparoscopic group.
Laparoscopy also proved safe in a Cleveland Clinic study reported at the Endocrine Society meeting in Toronto. In a record review, 44 morbidly obese patients lost about 100 pounds at a median 16.3 months. There were no deaths or conversions to open surgery. The median stay was four days.
Most postop complications were minor, including four wound infections treated as outpatients and anastomotic strictures dilated successfully in 12 patients. Ten other complications included prolonged respiratory failure, anastomotic leaks, hernia repair, pneumonia, and subphrenic abscess, the team reported.-Judith Groch
MEMPHIS-Add gastric bypass for morbid obesity to laparoscopy’s growing list of accomplishments.
