Abstracts
1999 Digestive Disease Week

# 2186 LAPAROSCOPIC ROUX-EN-Y GASTRIC BYPASS FOR SUPER-MORBID OBESITY
Philip Raymond Schauer, Univ of Pittsburgh, Pittsburbh, PA; Sayeed Ikramuddin, Univ of Pittsburgh Med Ctr, Pittsburbh, PA Pa; William Gourash, George Panzak, Univ of Pittsburgh, Pittsburbh, PA

The laparoscopic approach to Roux-Y Gastric Bypass (LRYGBP) significantly reduces perioperative morbidity, but has primarily been limited to patients with a (BMI < 50) because of technical limitations. The purpose of this study was to determine the safety and feasibility of LRYGBP in the high-risk, super-obese patient. Methods: Patients with a body mass index (BMI) ³ 50 (super-obese) were selected for LRYGBP. Short-term results were reviewed. Results: Since July 1997, 30 super-obese patients underwent LRYGBP with a 100-150 cm Roux-limb without conversion. Twenty-two of the patients were female and 12 had prior abdominal surgery. The mean age was 41 (range 27-54) and the mean BMI was 55 (range 50-67). Co-morbidity included hypertension (17), sleep apnea (17), hypercholesterolemia (16), heart disease (10) GERD (10), osteo-arthritis (9), chronic lung dz (6), and diabetes (4). The mean operating time was 4.8 hrs (range 3-7.5) and blood loss was 72 ml. Minor complications included 3 superficial wound infections, a UTI, one episode of hypokalemia, and a subclinical gastric pouch leak that resolved without operative repair. Two major complications included a gastric pouch leak that was successfully repaired and a postoperative small bowel obstruction. There were no major cardiopulmonary complications, wound dehiscences, hernias, or mortalities. The mean time to return to oral intake and hospital stay was 1.5 and 3.2 (median 2.0) days respectively. The mean time to return to work was 26.5 days. All patients have lost weight (mean 8.3 Kg/month) with a mean follow-up of 4 months (range 1-15). Conclusion: LRYGBP is feasible in the super-obese despite major technical challenges. Results are encouraging with short hospital stays and rapid recovery despite the long operating time.

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