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Laparoscopic technique for performing duodenal switch with gastric reduction
Robert A Rabkin1, John M Rabkin, Barbara Metcalf
1Pacific Laparoscopy, San Francisco, CA 94117, USA. rrabkin@pacificsurgery.com
Obesity Surgery
|May 13, 2003
Summary
The laparoscopic hand-assisted duodenal switch (LapDS) is a safe bariatric surgery for morbid obesity, offering significant excess weight loss. This procedure combines gastric reduction with intestinal shortening for effective weight management.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Surgery
- Obesity Management
Background:
- The duodenal switch (DS) procedure is a hybrid bariatric surgery for morbid obesity.
- It combines gastric reduction for intake restriction and intestinal shortening for malabsorption.
- This report details the laparoscopic hand-assisted technique (LapDS).
Purpose of the Study:
- To describe the laparoscopic hand-assisted duodenal switch (LapDS) technique.
- To evaluate the safety and efficacy of LapDS in morbidly obese patients.
Main Methods:
- A greater curvature gastrectomy reduces stomach capacity to 120 ml.
- The duodenum is divided and anastomosed to the distal ileum, creating a 100 cm common channel.
- Associated procedures include laparoscopic cholecystectomy, cholangiogram, liver biopsy, and appendectomy.
Main Results:
- 345 LapDS procedures were performed between 1999 and 2002.
- Mean BMI was 50 kg/m(2), with a mean operating time of 201 minutes.
- Mean excess weight loss reached 91% at 24 months, with no reported deaths.
Conclusions:
- Laparoscopic assisted duodenal switch (LapDS) is a safe bariatric procedure.
- It offers acceptable operative times and manageable morbidity.
- LapDS demonstrates significant long-term weight loss efficacy.