Laparoscopic Roux EN-Y gastric bypass technique and results in 150 cases

Introduction
Obesity is a major public health challenge in the 21st century, where medicopsychological management has shown its limitations. Bariatric surgery is now acknowledged as the most efficient therapy, potentially offered to severely obese patients. Among other options, Roux En-Y gastric bypass (RYGBP) is the most frequently performed procedure.
Patients and methods
This is a retrospective study of 150 patients who underwent a laparoscopic RYGBP at the Saint Maria Nouva Hospital (Reggio Emilia, Italy) and the Ain Shams University hospitals during 2011-2013 with a 1-year follow-up. There were 29 male (19%) and 121 female (81%) patients, with an age range of 18-58 years. Their mean BMI (kg/m΂) was 45.The outcome of this technique was evaluated by the incidence of early surgical postoperative complications, including gastrojejunostomy leakage, postoperative intra-abdominal bleeding or hematoma, reoperation, and mortality rate, and late postoperative complications, such as gastritis, vitamin deficiency, gastrojejunostomy stricture, incisional hernia, and internal hernia, after 12 months' follow-up. Weight loss was followed up every 3 months up to 12 months.
Results
The average operative time was ~75-90 min. There was no mortality in our series. Early postoperative intra-abdominal hematoma formation occurred in three cases (2%). Anastomotic leaks occurred at the gastrojejunostomy site in three cases (2%). There was no incidence of pulmonary complications or early postoperative wound infection. With long-term follow-up every 3 months up to 12 months, there was one case of incisional hernia after reoperation for leakage (0.6%) and there was no complain of gastritis, no incidence for gastrojejunostomy stricture, or internal hernia. There was no vitamin deficiency during the 12-months follow-up, except for two cases (1.2%) of iron deficiency anemia that needed additional iron supplementation. Regarding weight loss, the mean weight loss after 12 months' follow-up was 35.2 kg and the mean BMI of the patients decreased from 45 kg/m preoperatively to 32.3 kg/m after 12 months.
Conclusion
The primary desirable outcomes after bariatric surgery include low rates of perioperative and long-term complications, sustained and meaningful weight loss, significant improvement in the quality of life, improvement or resolution of obesity-associated comorbidities, and extension of life span. All the five outcomes have been shown to be feasible results of laparoscopic RYGBP.