Common Limb Length Does Not Influence Weight Loss After Standard Laparoscopic Roux-En-Y Gastric Bypass

Excerpt

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a standardised procedure, but the optimal lengths of the three bowel limbs are unknown [1, 2]. Navez et al. concluded that “With a fixed 150-cm ALL and a 75-cm BPLL, there is no evidence that the anatomical variations of CLL could influence weight loss after classical RYGBP” [3]. In the same time, we do not agree with Navez et al. We agree that the weight loss is mostly due to the biliopancreatic bypass (length of the biliopancreatic loop) and to the length of the common loop. In the methods section, the authors should have used a third group with a longer biliopancreatic loop. In practice, the whole length of the small bowel should be measured and the lengths of the loops chosen depending on the total length of the small bowel, rather than measuring the common loop at the end of the procedure. In addition, as Hess refers to in his article “measurements in duodenal switch”, the length of the three loops should be chosen according to the total length of the small bowel [4]. A multicentre trial, the DUCATI-study is currently ongoing and includes measurement of loops during the LRYGB. …