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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
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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
PubMed
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.

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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.