Purpose:
Bariatric surgery has well established efficacy in treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance weight loss and minimize weight regain. This study reports long term results from a cohort of patients undergoing a SR-MGBP.
Materials and Methods:
Long term outcomes (upto 11 years) in a cohort of patients undergoing surgery between August 2005 and January 2008 were analysed. A combination of questionnaires and electronic hospital records were used to assess weight loss, comorbidity resolution and complications.
Results:
156 patients underwent surgery. 92 patients responded to the questionnaires. Computer based hospital information was available on 139 patients. Mean percent excess weight loss (%EWL) at 11 years was 84.3%. Comorbidity resolution determined by medication use showed a reduction in diabetes (21.8% to 7.1%), hypertension (37.2% to 21.4%) and hypercholesterolaemia (40.4% to 13.4%). 3.6% of patients had SR problems needing removal. Two patients had the SR changed and two others had endoscopic removal of the SR for erosion. 9.4% of patients required conversion to a RYGBP. The number of patients on anti-reflux medications increased from 5.1% to 44.6%. There were two deaths unrelated to surgery.
Conclusions:
SR-MGBP appears to be a safe and effective operation for the morbidly obese. The SR problems can be managed easily and is reasonable to consider when performing a MGBP. Concerns about bile reflux appear to be well founded and some patients require revision.