ArticleJSLS : Journal of the Society of Laparoendoscopic Surgeons
Procedural changes to decrease complications in laparoscopic gastric bypass.
Article in JSLS : Journal of the Society of Laparoendoscopic Surgeons. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed, 12 citations in OpenAlex.
- FIXING JEJUNAL MANEUVER TO PREVENT PETERSEN HERNIA IN GASTRIC BYPASS.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2015Article
- Decreasing Surgical Site Infection Associated with the Use of Circular Staplers During Roux-En-Y Gastric Bypass.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectivesLaparoscopic Roux-en-Y gastric bypass (LRYGB) is a complex procedure performed in a patient population with significant medical comorbidities. Evaluation and modification of surgical techniques can minimize the complications associated with the lengthy learning curve for this procedure. The purpose of this study was to evaluate a single surgeon's decade-long experience with LRYGB, to determine whether complications decreased with experience and surgical modifications improved perioperative outcomes.
methodsA retrospective review of all procedures performed by a fellowship-trained surgeon (MK) from December 1, 2000, to October 31, 2013, identified patients who underwent LRYGB. We evaluated perioperative outcomes in 1117 patients and examined the impact of modification of surgical techniques on complications. The patients were divided into 4 groups: cases 1-100 (group 1), cases 101-400 (group 2), cases 401-700 (group 3), and cases 701-1117 (group 4).
resultsOperating time decreased significantly after the initial 100 cases, from 179.1 minutes for group 1 to 122.1 minutes for group 4. With experience, early complication rates improved from 25.0% to 5.0%, but the rates of early reoperation increased from 1.0% to 2.2% over the 4 case groups. Late complication and reoperation rates increased from 4.0% to 10.5%. However, rates of bleeding, early stricture, internal hernia, and wound infection all decreased after the modification of surgical techniques.
conclusionsOperating time and early complication rates decreased with operative experience, but late complication and early and late reoperation rates increased. However, after modifications of surgical technique, common complications of LRYGB decreased to rates lower than those reported in several gastric bypass case series in the literature. The findings in this study will be helpful to fellow bariatric surgeons who are refining their strategies for reducing morbidity related to LRGYB.
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