Abstracts
1998 Digestive Disease Week

#2321

LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS: INITIAL RESULTS. P.R. Schauer S. Ikramuddin, W. Gourash. Department of Surgery, University of Pittsburgh, Pittsburgh, PA. USA.

Introduction: Roux-en-Y Gastric Bypass has been shown to be very effective in producing significant weight loss in clinically severe obese patients; however, it is associated with significant perioperative morbidity related to the laparotomy for access. The purpose of this study was to determine the short-term outcome of a laparoscopic approach to gastric bypass surgery (Lap GBP). Methods: Patients who met criteria for clinically severe obesity with a body mass index (BMI) between 40 and 55 and age less than 50 were selected for laparoscopic gastric bypass. Short-term results were reviewed. Results: Between July 1997 and December 1997, 10 patients underwent Lap GBP with a 15-30 ml gastric pouch, 21 mm stapled end-end gastro-jejunal anastomosis, 75-100 cm Roux limb, and stapled functional end-end jejuno-jejunostomy. Five trocar incisions were used (5mm-15mm). All but one of the patients were female. The mean age was 34 (range 27 to 49) and the mean BMI was 44 (range 40 to 53). All patients had a least one co-morbidity including GERD(6), hypertension(5), sleep apnea(4), joint disease(3), diabetes(1), and coronary artery disease(1). The mean operating time was 7 hrs (range 4.5-10 hrs) and blood loss was 147 ml (range 25-250 ml). Nine patients had procedures completed laparoscopically. One patient (the first attempt) required conversion to laparotomy because of stapler malfunction. The return to oral intake and hospital stay for all 9 Lap GBP was 1.3 and 2 days respectively and 3 and 6 days respectively for the one conversion. No patients required ICU stay. The average time to return to full activity was 19 days. Two complications occurred. One patient developed cardiac ischemia on postoperative day 26 and underwent emergent angioplasty with no residual myocardial damage. Another patient developed a wound infection that resolved with PO antibiotics. All patients have lost weight (mean 7Kg/month) with a mean follow-up of 3 months. Conclusion: Preliminary results of laparoscopic Roux-en-Y Gastric Bypass are encouraging with short hospital stays and rapid recovery despite the long operating time of this technically demanding procedure. Further analysis will be required to determine long-term weight loss.

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