Skip to main content
Top
Published in: Obesity Surgery 9/2010

01-09-2010 | Clinical Research

Influence of the Actual Diameter of the Gastric Pouch Outlet in Weight Loss After Silicon Ring Roux-en-Y Gastric Bypass: An Endoscopic Study

Authors: Jorge Mali Jr., Fernando Augusto Mardiros Herbella Fernandes, Antonio Carlos Valezi, Tiemi Matsuo, Mariano de Almeida Menezes

Published in: Obesity Surgery | Issue 9/2010

Login to get access

Abstract

Some sort of restriction of the pouch emptying is supported by many surgeons to allow a sustained weight loss through the use of a ring placed circumferentially around the gastric pouch. Most previous studies focused on the length of the ring, not the actual diameter of the gastric pouch outlet. This study aims to evaluate the association between the actual diameter of the gastric pouch outlet and the weight loss in obese patients submitted to silicon ring Roux-en-Y gastric bypass. We studied prospectively 257 patients that underwent silicon ring (65 mm) Roux-en-Y gastric bypass between July 2005 and August 2007. Upper digestive endoscopy was performed to measure the diameter of the gastric pouch outlet at 1 and 2 years with the aid of calibrated balloons. The diameter of the gastric pouch outlet ranged from 9 to 14 mm (mean = 11 mm). Excess weight loss ranged from 37% to 127% (mean = 69%) during the first year and 29% to 110% (mean = 69%) during the second year. A negative correlation between the diameter of the gastric pouch outlet and excess weight loss at first year (r = −0.792, p < 0.001) and at the second year of follow-up (r = −0.921, p < 0.001) was found. The actual diameter of the gastric pouch outlet was associated with weight loss after silicon ring Roux-en-Y gastric bypass during the 2-year follow-up.
Literature
1.
go back to reference Talieh J, Kirgan D, Fisher BL. Gastric bypass for morbid obesity: a standard surgical technique by consensus. Obes Surg. 1997;7(3):198–202.CrossRefPubMed Talieh J, Kirgan D, Fisher BL. Gastric bypass for morbid obesity: a standard surgical technique by consensus. Obes Surg. 1997;7(3):198–202.CrossRefPubMed
2.
go back to reference Fobi MAL, Lee H. The surgical technique of the Fobi-pouch operation for obesity (The transected Silastic® vertical gastric bypass). Obes Surg. 1998;8(3):283–8.CrossRefPubMed Fobi MAL, Lee H. The surgical technique of the Fobi-pouch operation for obesity (The transected Silastic® vertical gastric bypass). Obes Surg. 1998;8(3):283–8.CrossRefPubMed
3.
go back to reference Capella RF, Capella JF, Mandac H, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1:389–95.CrossRefPubMed Capella RF, Capella JF, Mandac H, et al. Vertical banded gastroplasty-gastric bypass: preliminary report. Obes Surg. 1991;1:389–95.CrossRefPubMed
4.
go back to reference Crampton NA, Izvornikov V, Stubbs RS. Silastic® ring gastric bypass: a comparison of two ring sizes: a preliminary report. Obes Surg. 1997;7(6):495–9.CrossRefPubMed Crampton NA, Izvornikov V, Stubbs RS. Silastic® ring gastric bypass: a comparison of two ring sizes: a preliminary report. Obes Surg. 1997;7(6):495–9.CrossRefPubMed
5.
go back to reference Crampton NA, Izvornikov V, Stubbs RS. Silastic® ring gastric bypass: results in 64 patients. Obes Surg. 1997;7(6):489–94.CrossRefPubMed Crampton NA, Izvornikov V, Stubbs RS. Silastic® ring gastric bypass: results in 64 patients. Obes Surg. 1997;7(6):489–94.CrossRefPubMed
6.
go back to reference Fobi MAL, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001;11:699–707.CrossRefPubMed Fobi MAL, Lee H, Igwe D, et al. Band erosion: incidence, etiology, management and outcome after banded vertical gastric bypass. Obes Surg. 2001;11:699–707.CrossRefPubMed
7.
go back to reference Arasaki CH, DelGrande JC, Yanagita ET, et al. Incidence of regurgitation after the banded gastric bypass. Obes Surg. 2005;15(10):1408–1.CrossRefPubMed Arasaki CH, DelGrande JC, Yanagita ET, et al. Incidence of regurgitation after the banded gastric bypass. Obes Surg. 2005;15(10):1408–1.CrossRefPubMed
8.
go back to reference Valezi AC, Brito EM, Souza JCL, et al. Importance of silicon ring in Roux-en-Y gastric bypass for treatment of obesity. Surg Braz Coll Rev. 2008;35(1):18–22. Valezi AC, Brito EM, Souza JCL, et al. Importance of silicon ring in Roux-en-Y gastric bypass for treatment of obesity. Surg Braz Coll Rev. 2008;35(1):18–22.
9.
go back to reference Mali Junior J, Valezi AC, Menezes MCL. Weight loss outcome after silastic ring Roux-en-Y gastric bypass: five years of follow-up. Obes Surg. 2007;17:1287–91.CrossRef Mali Junior J, Valezi AC, Menezes MCL. Weight loss outcome after silastic ring Roux-en-Y gastric bypass: five years of follow-up. Obes Surg. 2007;17:1287–91.CrossRef
10.
go back to reference Fobi MA, Lee H, Felahy B, et al. Choosing an operation for weight control, and the transected banded gastric bypass. Obes Surg. 2005;15:114–21.CrossRefPubMed Fobi MA, Lee H, Felahy B, et al. Choosing an operation for weight control, and the transected banded gastric bypass. Obes Surg. 2005;15:114–21.CrossRefPubMed
11.
go back to reference Fobi MAL, Lee H. Silastic ring vertical banded gastric bypass for the treatment of obesity. J Natl Med Assoc. 1994;86:125–8.PubMed Fobi MAL, Lee H. Silastic ring vertical banded gastric bypass for the treatment of obesity. J Natl Med Assoc. 1994;86:125–8.PubMed
12.
go back to reference Salinas A, Santiago E, Yegues J, et al. Silastic ring vertical gastric bypass: evolution of an open surgical technique, and review of 1, 588 cases. Obes Surg. 2005;15:1403–7.CrossRefPubMed Salinas A, Santiago E, Yegues J, et al. Silastic ring vertical gastric bypass: evolution of an open surgical technique, and review of 1, 588 cases. Obes Surg. 2005;15:1403–7.CrossRefPubMed
13.
go back to reference Capella RF, Capella JF. Reducing early technical complications in gastric bypass surgery. Obes Surg. 1997;7:149–57.CrossRefPubMed Capella RF, Capella JF. Reducing early technical complications in gastric bypass surgery. Obes Surg. 1997;7:149–57.CrossRefPubMed
14.
go back to reference White S, Brooks E, Jurikova L, et al. Long-term outcomes after gastric bypass. Obes Surg. 2005;15:155–63.CrossRefPubMed White S, Brooks E, Jurikova L, et al. Long-term outcomes after gastric bypass. Obes Surg. 2005;15:155–63.CrossRefPubMed
15.
go back to reference Awad W, Garay A, Onate VH, et al. Gastric bypass with and without a ring: the effect on weight reduction and quality of life. Obes Surg. 2005;15:724. abst. Awad W, Garay A, Onate VH, et al. Gastric bypass with and without a ring: the effect on weight reduction and quality of life. Obes Surg. 2005;15:724. abst.
16.
go back to reference Dapri G, Cadière GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-y gastric bypass. Obes Surg. 2009;19(5):650–4.CrossRefPubMed Dapri G, Cadière GB, Himpens J. Laparoscopic placement of non-adjustable silicone ring for weight regain after Roux-en-y gastric bypass. Obes Surg. 2009;19(5):650–4.CrossRefPubMed
17.
go back to reference Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4(4):353–7.CrossRefPubMed Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg. 1994;4(4):353–7.CrossRefPubMed
18.
go back to reference Higa KD, Boone KB, Ho T. Complications of the laparoscopic Roux-en-Y gastric bypass: 1, 040 patients—what have we learned? Obes Surg. 2000;10(6):509–13.CrossRefPubMed Higa KD, Boone KB, Ho T. Complications of the laparoscopic Roux-en-Y gastric bypass: 1, 040 patients—what have we learned? Obes Surg. 2000;10(6):509–13.CrossRefPubMed
19.
go back to reference Laws HL, Piantadosi S. Superior gastric reduction procedure for morbid obesity. Ann Surg. 1981;193:334–40.CrossRefPubMed Laws HL, Piantadosi S. Superior gastric reduction procedure for morbid obesity. Ann Surg. 1981;193:334–40.CrossRefPubMed
20.
go back to reference MacArthur RI, Smith DE, Hermreck AS, et al. Revision of gastric bypass. Am J Surg. 1980;140(6):751–4.CrossRefPubMed MacArthur RI, Smith DE, Hermreck AS, et al. Revision of gastric bypass. Am J Surg. 1980;140(6):751–4.CrossRefPubMed
21.
go back to reference Holzwarth R, Huber D, Majkrzak A, et al. Outcome of fastric bypass patients. Obes Surg. 2002;12:261–4.CrossRefPubMed Holzwarth R, Huber D, Majkrzak A, et al. Outcome of fastric bypass patients. Obes Surg. 2002;12:261–4.CrossRefPubMed
22.
go back to reference Kirkpatrick JR, Siegel T. Critical determinants of a successful gastric bypass. Obes Surg. 1982;77:464–6. Kirkpatrick JR, Siegel T. Critical determinants of a successful gastric bypass. Obes Surg. 1982;77:464–6.
23.
go back to reference Fobi MAL, Lee H, Holness R, et al. Gastric bypass operation for obesity. World J Surg. 1998;22(9):925–35.CrossRefPubMed Fobi MAL, Lee H, Holness R, et al. Gastric bypass operation for obesity. World J Surg. 1998;22(9):925–35.CrossRefPubMed
24.
go back to reference Linner JH, Drew RL. New modification of Roux-en-Y gastric bypass procedure. Clin Nutr. 1986;5:33–7.CrossRef Linner JH, Drew RL. New modification of Roux-en-Y gastric bypass procedure. Clin Nutr. 1986;5:33–7.CrossRef
25.
go back to reference Fobi MAL, Lee H, Flemming A. The surgical technique of the banded Roux-en-Y gastric bypass. J Obes Weight Reg. 1989;8(2):99–102. Fobi MAL, Lee H, Flemming A. The surgical technique of the banded Roux-en-Y gastric bypass. J Obes Weight Reg. 1989;8(2):99–102.
26.
go back to reference Stubbs RS, O'Brien I, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16:1298–303.CrossRefPubMed Stubbs RS, O'Brien I, Jurikova L. What ring size should be used in association with vertical gastric bypass? Obes Surg. 2006;16:1298–303.CrossRefPubMed
27.
go back to reference Shai I, Henkin Y, Weitzman S, et al. Determinants of long-term satisfaction after vertical banded gastroplasty. Obes Surg. 2003;13:269–74.CrossRefPubMed Shai I, Henkin Y, Weitzman S, et al. Determinants of long-term satisfaction after vertical banded gastroplasty. Obes Surg. 2003;13:269–74.CrossRefPubMed
28.
go back to reference Mason EE, Doherty C, Cullen JJ, et al. Vertical gastroplasty: evolution of vertical banded gastroplasty. World J Surg. 1998;22:919–24.CrossRefPubMed Mason EE, Doherty C, Cullen JJ, et al. Vertical gastroplasty: evolution of vertical banded gastroplasty. World J Surg. 1998;22:919–24.CrossRefPubMed
29.
go back to reference Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass. Am J Surg. 1996;171:74–9.CrossRefPubMed Capella JF, Capella RF. The weight reduction operation of choice: vertical banded gastroplasty or gastric bypass. Am J Surg. 1996;171:74–9.CrossRefPubMed
Metadata
Title
Influence of the Actual Diameter of the Gastric Pouch Outlet in Weight Loss After Silicon Ring Roux-en-Y Gastric Bypass: An Endoscopic Study
Authors
Jorge Mali Jr.
Fernando Augusto Mardiros Herbella Fernandes
Antonio Carlos Valezi
Tiemi Matsuo
Mariano de Almeida Menezes
Publication date
01-09-2010
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 9/2010
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-010-0189-9

Other articles of this Issue 9/2010

Obesity Surgery 9/2010 Go to the issue