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Laparoscopic silastic ring mini-gastric bypass: a single centre experience
M G Clarke1, K Wong, L Pearless
1Department of Bariatric and Upper GI Surgery, North Shore Hospital, Private Bag 93-503, Takapuna, Auckland, 0740, New Zealand, mgclarkey@doctors.org.uk.
Obesity Surgery
|July 10, 2013
Summary
Silastic ring laparoscopic mini-gastric bypass (SR-MGBP) shows excellent excess weight loss (EWL) and low mortality. However, the silastic ring is associated with a high incidence of food intolerance and vomiting, with some patients requiring reoperation.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Procedures
- Obesity Management
Background:
- Laparoscopic mini-gastric bypass (MGBP) offers a simplified approach compared to Roux-en-Y gastric bypass.
- Incorporating a silastic ring (SR) may enhance weight loss and reduce regain.
- This study evaluates outcomes of SR-MGBP in a single center cohort.
Purpose of the Study:
- To assess the short- and medium-term efficacy and safety of silastic ring laparoscopic mini-gastric bypass (SR-MGBP).
- To evaluate weight loss, comorbidity resolution, and complication rates associated with SR-MGBP.
Main Methods:
- Analysis of 156 consecutive SR-MGBP patients from August 2005 to January 2008.
- Assessment of weight loss (% excess weight loss - EWL), comorbidity resolution, and morbidity/mortality.
- Median follow-up of 35 months.
Main Results:
- Mean %EWL reached 93.4% at 12 months and remained high at 89% at 60 months.
- 37% of patients experienced complete comorbidity resolution; 67.3% required vitamin/mineral supplementation.
- 10.3% early and 45.5% late complications occurred, with food intolerance/vomiting (18.6%) and bile reflux (10.3%) being common. No deaths were reported.
Conclusions:
- SR-MGBP demonstrates significant excess weight loss (EWL) and low mortality.
- High rates of food intolerance/vomiting are linked to the silastic ring, necessitating management.
- While most complications are managed non-surgically, approximately 13% of patients required reoperation within 5 years.
