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Obesity Surgery
Published in: Obesity Surgery 10/2009

Open Access 01-10-2009 | Clinical Report

Standardization of the Fully Stapled Laparoscopic Roux-en-Y Gastric Bypass for Obesity Reduces Early Immediate Postoperative Morbidity and Mortality: A Single Center Study on 2606 Patients

Authors: Bruno Dillemans, Nasser Sakran, Sebastiaan Van Cauwenberge, Thibault Sablon, Barbara Defoort, Els Van Dessel, Faki Akin, Nathalie Moreels, Sebastiaan Lambert, Jan Mulier, Ravindra Date, Michel Vandelanotte, Tom Feryn, Luc Proot

Published in: Obesity Surgery | Issue 10/2009

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Abstract

Background

Various techniques of laparoscopic Roux-en-Y gastric bypass have been described. We completely standardized this procedure to minimize its sometimes substantial morbidity and mortality. This study describes our experience with the standardized fully stapled laparoscopic Roux-en-Y gastric bypass (FS-LRYGB) and its influence on the 30-day morbidity and mortality.

Methods

We retrospectively analyzed 2,645 patients who underwent FS-LRYGB from May 2004 to August 2008. Operative time, hospital stay and readmission, re-operation, and 30-day morbidity/mortality rates were then calculated. The 30-day follow-up data were complete for 2,606 patients (98.5%).

Results

There were 539 male and 2,067 female patients. Mean age was 39.2 years (range 14–73), mean BMI 41.44 kg/m2 (range, 23–75.5). The mean hospital stay was 3.35 days (range 2–71). Mean total operative time was 63 min (range 35–150).
One patient died of pneumonia within 30 days of surgery (0.04%). One hundred and fifty one (5.8%) patients had postoperative complications as follows: gastrointestinal hemorrhage (n = 89, 3.42%), intestinal obstruction (n = 9, 0.35%), anastomotic leak (n = 5, 0.19%) and others (n = 47, 1.80%). In 66 patients, the bleeding resolved without any surgical re-intervention. One hemorrhage resulted in hypovolemic shock with subsequent renal and hepatic failure.

Conclusion

The systematic approach and the full standardization of the FS-LRYGB procedure contribute highly to the very low mortality and the low morbidity rates in our institution. Gastrointestinal bleeding appears to be the commonest complication, but is self-limiting in the majority of cases. Our approach also significantly reduces operative time and turns the technically demanding laparoscopic Roux-en-Y gastric bypass procedure into an easy reproducible operation, effective for training.
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Metadata
Title
Standardization of the Fully Stapled Laparoscopic Roux-en-Y Gastric Bypass for Obesity Reduces Early Immediate Postoperative Morbidity and Mortality: A Single Center Study on 2606 Patients
Authors
Bruno Dillemans
Nasser Sakran
Sebastiaan Van Cauwenberge
Thibault Sablon
Barbara Defoort
Els Van Dessel
Faki Akin
Nathalie Moreels
Sebastiaan Lambert
Jan Mulier
Ravindra Date
Michel Vandelanotte
Tom Feryn
Luc Proot
Publication date
01-10-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 10/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-9933-4

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