A Laparoscopic Approach Decreases Wound-Related Complications Following Roux-en-Y Gastric Bypass.
Abstracts
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Purpose: Severely obese patients are at high risk for wound-related problems, and a high incidence of wound-related morbidity has been reported following all forms of open gastric bypass surgery. We hypothesized that a laparoscopic approach to this operation would result in fewer wound-related problems. Methods: We retrospectively reviewed our 15 year single institution bariatric surgical experience and compared wound and incisional complications (defined as wound infection, dehiscence, seroma, or subsequent incisional hernia formation) following the performance of open Roux-en-Y gastric bypass (RYGB) with performance of RYGB using a laparoscopic approach. Results: Of 584 patients undergoing open RYGB, 186 (31.8%) were documented to have developed some type of wound or incisional problem. Eighty-five patients (14.6%) developed incisional hernias, 60 (10.3%) developed seromas, 37 (6.3%) developed wound infections, and three (0.5%)had dehiscences. The 83 patients undergoing laparoscopic RYGB had a significantly lower incidence of wound related problems (7%, p<.01). Five patients (6.0%) developed wound infections (p=ns), and one patient had a postoperative seroma (p<.01). There have been no incisional hernias in the laparoscopic group (p<.01). Conclusion: Performance of RYGB using a laparoscopic approach significantly decreases the overall incidence of wound-related problems associated with open RYGB by decreasing the incidence of wound seromas and subsequent incisional hernias. |
