Outcomes After Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

TLDR

Laparoscopic Roux‑en‑Y gastric bypass is a highly effective treatment for morbid obesity that can reduce perioperative complications and shorten recovery time. The study evaluates short‑term outcomes of laparoscopic Roux‑en‑Y gastric bypass in 275 patients followed for 1–31 months. The procedure created a 15‑mL gastric pouch and a 75‑cm Roux limb (150 cm for superobese) using five or six trocar incisions, with a 1% conversion rate to open surgery; patients began oral diet ~1.6 days post‑op, had a median 2‑day hospital stay, and returned to work in 21 days. Early major and minor complication rates were 3.3% and 27%, respectively, with a 0.4% mortality from pulmonary embolism; hernia and wound infection rates were 0.7% and 5%; excess weight loss was 83% at 24 months and.

Abstract

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.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.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.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.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.