Laparoscopic versus open gastric bypass in the treatment of morbid obesity: a randomized prospective study.

Departamento de Cirugía General, Hospital Universitario Virgen de la Arrixaca, 30120 El Palmar, Murcia, Spain.
Annals of Surgery (Impact Factor: 7.19). 04/2004; 239(4):433-7. DOI: 10.1097/01.sla.0000120071.75691.1f
Source: PubMed

ABSTRACT The objective of the study was to compare the results of open versus laparoscopic gastric bypass in the treatment of morbid obesity.
Gastric bypass is one of the most commonly acknowledged surgical techniques for the management of morbid obesity. It is usually performed as an open surgery procedure, although now some groups perform it via the laparoscopic approach.
Between June 1999 and January 2002 we conducted a randomized prospective study in 104 patients diagnosed with morbid obesity. The patients were divided into 2 groups: 1 group with gastric bypass via the open approach (OGBP) comprising 51 patients, and 1 group with gastric bypass via the laparoscopic approach (LGBP) comprising 53 patients. The parameters compared were as follows: operating time, intraoperative complications, early (<30 days) and late (>30 days) postoperative complications, hospital stay, and short-term evolution of body mass index.
Mean operating time was 186.4 minutes (125-290) in the LGBP group and 201.7 minutes (129-310) in the OGBP group (P < 0.05). Conversion to laparotomy was necessary in 8% of the LGBP patients. Early postoperative complications (<30 days) occurred in 22.6% of the LGBP group compared with 29.4% of the OGBP group, with no significant differences. Late complications (>30 days) occurred in 11% of the LGBP group compared with 24% of the OGBP group (P < 0.05). The differences observed between the 2 groups are the result of a high incidence of abdominal wall hernias in the OGBP group. Mean hospital stay was 5.2 days (1-13) in the LGBP group and 7.9 days (2-28) in the OGBP group (P < 0.05). Evolution of body mass index during a mean follow-up of 23 months was similar in both groups.
LGBP is a good surgical technique for the management of morbid obesity and has clear advantages over OGBP, such as a reduction in abdominal wall complications and a shorter hospital stay. The midterm weight loss is similar with both techniques. One inconvenience is that LGBP has a more complex learning curve than other advanced laparoscopic techniques, which may be associated with an increase in postoperative complications.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Laparoscopic appendectomy has become favored over open surgical methods for its association with decreased postoperative pain, more rapid return to daily activities, and improved cosmetic results. Mini-incision appendectomy was being performed in our clinic for a long time especially in patients with noncomplicated appendicitis and in patients with appropriate body mass index. Although laparoscopy presents obvious advantages especially for obese patients and young women, with respect to the results of our study, mini-incision appendectomy seems to be an alternative for selected patient groups.
    Gastroenterology Research and Practice 01/2014; 2014:138648. DOI:10.1155/2014/138648 · 1.50 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Ventral incisional hernia is a common complication of abdominal surgery. The marked improvements in medical technology and healthcare, lead to an increasing number of elderly patients to take advantage of even complex surgical procedures. The objective of this literature review was to analyze the risk factors for ventral incisional hernia in elderly patients and to identify measures that might decrease the incidence of this complication. Materials and methods: An analysis of the surgical literature was performed using the search engines EMBASE, Cochrane Library, and PubMed with particular reference to elderly patients using the keywords: abdominal hernia, wound dehiscence, incisional hernia, incidence, trocar site hernia, and hernia prevention. Results: In our opinion the risk factors for incisional hernia should be separately considered. First those related to the patients and to the abdominal surgery and, in addition, those related to the surgery of the abdominal wall defects. Conclusions: Reparative surgery of the abdominal wall, to date uniquely characterized by the use of the mesh, should be considered an additional risk factor for the occurrence of incisional hernia. However, the low incarceration risk, the risk of recurrence, the relevant rate of postoperative pain and discomfort and complications associated with mesh repair, as small bowel obstruction, mesh infection, and entero-cutaneous fistula, suggest that the general indication for surgical treatment of incisional hernias, in a symptomatic or oligosymptomatic elderly patients, should be critically reconsidered in order to avoid unnecessary surgery.
    International Journal of Surgery 08/2014; DOI:10.1016/j.ijsu.2014.08.357 · 1.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Laparoscopic Sleeve Gastrectomy (LSG) is a relatively new procedure that is gaining wide acceptance. However, laparoscopic Roux-en-Y Gastric Bypass (LRYGB) remains one of the most commonly performed bariatric procedures with the best long-term results. There are few studies comparing LSG with LRYGB. The aim of this study is to compare the safety and outcome of LSG to LRYG in a single accredited center.
    Obesity Surgery 08/2014; 25(2). DOI:10.1007/s11695-014-1388-6 · 3.74 Impact Factor

Full-text (2 Sources)

Available from
May 16, 2014