Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 7/2008

01-07-2008 | Research Article

An Analysis of Gastric Pouch Anatomy in Bariatric Surgery

Authors: Rafael F. Capella, Vincent A. Iannace, Joseph F. Capella

Published in: Obesity Surgery | Issue 7/2008

Login to get access

Abstract

Background

The goal of most bariatric surgeons has been to construct small volume pouches in the proximal stomach to restrict the intake of food. The purpose of this study is to demonstrate that in addition to pouch volume, specific gastric pouch anatomy plays a significant role in weight loss.

Materials and Methods

The physical properties and dynamics of the pouch in our form of gastric bypass were compared with those in the most commonly performed bariatric procedures by creating a model. Our weight loss data were reviewed and compared with data reported in the literature.

Results

According to LaPlace’s and Poiseulle’s Laws, a long narrow cylinder will have less wall tension and slower flow rate of material than a wider cylinder. Bariatric procedures with narrow pouches appear to produce better weight loss.

Conclusions

Long narrow pouches should have less tendency to enlarge and should delay the transit of material to a greater degree than wider pouches according to the LaPlace’s and Poiseuille’s Laws. Our data and the data of others strongly suggest that long narrow pouches are the most effective operations in bariatric surgery.
Literature
1.
Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;182:1345–52.
2.
Carrasquilla C, English WJ, Esposito P, Gianos J. Total stapled, total-intrabdominal (TSTI) laparoscopic Roux-en-Y gastric bypass: one leak in 1000 cases. Obes Surg. 2004;14:613–17.PubMedCrossRef
3.
Capella JF, Capella RF. An Assessment of vertical banded gastroplasty-Roux-en-Y gastric bypass for the treatment of morbid obesity. Am J Surg. 2002;183:117:123.PubMedCrossRef
4.
Flickenger EG, Pories WJ, Meelheim HD, et al. The Greenville gastric bypass progress report at 3 years. Ann Surg. 1984;199:555–62.CrossRef
5.
Huerta S, DeShields S, Shipiner R, Zhaoping L, Liu C, Sawicki M, Orteaga J, Livingston EH. Safety and efficacy of postoperative continuos positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. J Gastrointestinal Surg. 2002;6:354–8.CrossRef
6.
Wittgrove AC, Clark GW, Schubert K. Laparoscopic gastric bypass, Roux-en-Y; Roux-en-Y technique and results 75 patients with 3–30 month follow-up. Obes Surg. 1996;6:500–4.PubMedCrossRef
7.
Richard SD, Sherer RA. Johnston D, Seevers CE. Comparison of 21 vs. 25 mm gastrojejunostomy in the gastric bypass procedure—early results. Obes Surg. 2000;10:540–2.CrossRef
8.
Matthews BD, Sing RF, DeLegge MH, Ponsky JL, Heniford BT. Initial results with a stapled gastrojejunostomy for the laparoscopic isolated Roux-en-Y gastric bypass. Am J Surg. 2000;6:476–81.CrossRef
9.
Inabnet WB, Quinn T, Gagner M, Urban M, Pomp A. Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. Obes Surg. 2005;15:51–7.PubMedCrossRef
10.
Capella JF, Capella RF. Bariatric surgery in adolescence. Is this the best age to operate? Obes Surg. 2003;13:826–32.PubMedCrossRef
11.
Iannace V, Capella RF, Ballantyne G, Capella JF. Poster at 22nd Annual Meeting of the American Society for Bariatric Surgery. Orlando, Florida, USA June 26 to July 1, 2005.
12.
American Society for Bariatric Surgery Guidelines. ASBS Brochure. Adopted 22 October 1986.
13.
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y −500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10:233–9.PubMedCrossRef
14.
O’Brien PE, Dixon JB, Brown W, et al. The laparoscopic adjustable gastric band (Lap-Band@): a prospective study of medium-term effects on weight, health and quality of life. Obes Surg. 2002;12:652–60.PubMedCrossRef
15.
Robinson J, Sue-Ling H, Johnston D. The magenstrasse and mill procedure can be combined with a Roux-en-Y gastric bypass to produce greater and sustained weight loss. Obes Surg. 2006 July;16(7):891–6;(6).PubMedCrossRef
16.
Yale CE. Gastric surgery for morbid obesity: complications and long term weight control. Arch Surg. 1989;124:941–6.PubMed
17.
Pories WJ, Swanson M, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective theraphy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–52.PubMedCrossRef
18.
Balsiger BM, Kennedy FP, Abu-Lebdeh HS, et al. Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clin Proc. 2000;75:673–80.PubMed
19.
Higa KD, Tienchin HO, Boone KB. Laparoscopic Roux-en-Y gastric bypass: technique and 3-year follow-up. J Laparoendosc. 2001;11:377–82.CrossRef
20.
MacLean LD, Rhode BM, Nohr CW. Late outcome of isolated gastric bypass. Ann Surg. 1999;231:524–8.CrossRef
21.
Fobi MA, Lee H, Holness R, et al. Gastric bypass operation for obesity. World J Surg. 1998;22:925–35.
22.
Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–54.PubMedCrossRef
23.
Deitel M, Khanna RK, Hagan J. Vertical banded gastroplasty as an antireflux procedure. Am J Surg. 1988;155:512–6.PubMedCrossRef
24.
Balsiger BM, Kennedy FP, Abu-Lebdeh HS, et al. Prospective evaluation of Roux-en-Y gastric bypass as primary operation for medically complicated obesity. Mayo Clin Proc. 2000;75:673–80.PubMedCrossRef
25.
Liedman B, Bosaeus I, Hugosson I, Lundell L. Long-term beneficial effects of a gastric reservoir on weight control after total gastrectomy: a study of potential mechanisms. Br J Surg. 1998;85: 542–7.PubMedCrossRef
26.
Bostwick J. Augmentation mammoplasty. In: Bostwick J, editor. Plastic and reconstructive breast surgery. 2nd ed. St. Louis: Quality Medical Publising; 2000. p. 239–370.
27.
Mal F. Why the operation I prefer is Silastic ring vertical gastric bypass. Obes Surg. 1991;1:423–6.CrossRef
28.
Fobi MAL, Lee H. The surgical technique of the Fobi-Pouch operation for obesity (The Transected Silastic Vertical Gastric Bypass). Obes Surg. 1998;8:283–8.PubMedCrossRef
29.
Fobi MAL, Lee H, Felahy B, et al. Fifty consecutive patients with the GaBP ring system in the banded gastric bypass operation for obesity with follow up of at least 1 year. Surg Obes Relat Disease. 2005;1:569–72.CrossRef
30.
Stubbs RS, O’Brien Inga, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16:1298–303.PubMedCrossRef
31.
Bessler M, Daud A, Digiorgi MF, Olivero-Rivera L, Blok J. Prospective randomized double blinded trial of banded versus standard gastric bypass in patients with superobesity—early results. Presented at the 23rd Annual Meeting of the American Society for Bariatric Surgery, June 26–July 1, 2006.
32.
Marceau P, Hould FS, Simard S, et al. Biliopancreatic diversion with duodenal switch. World J Surg. 1998;22:947–54.PubMedCrossRef
Metadata
Title
An Analysis of Gastric Pouch Anatomy in Bariatric Surgery
Authors
Rafael F. Capella
Vincent A. Iannace
Joseph F. Capella
Publication date
01-07-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 7/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9303-z

Other articles of this Issue 7/2008

Obesity Surgery 7/2008 Go to the issue

Research Article

A Prospective Evaluation of a Variant of Biliopancreatic Diversion with Roux-en-Y Reconstruction in Mega-obese Patients (BMI ≥ 70 kg/m2)

Case Report

Leukocyte Scintigraphy SPECT/CT Software Fusion Diagnosis of Infected Gastric Band

Research Article

Hunger Control and Regular Physical Activity Facilitate Weight Loss After Laparoscopic Adjustable Gastric Banding

Case Report

Natural Orifice Surgery (NOS) Using StomaphyX™ for Repair of Gastric Leaks after Bariatric Revisions

Editorial

The Evolution of IFSO

Case Report

Laparoscopic Adjustable Gastric Banding for Morbid Obesity in a Patient with Situs Inversus Totalis