title: Silastic ring gastric bypass: results in 64 patients.
abstract: BACKGROUND
  The silastic ring gastric bypass (SRGB) was introduced by Fobi in 1989, in an effort to combine the advantages of the Roux-en-Y gastric bypass with those of the vertical banded gastroplasty, while avoiding the disadvantages of each.
  
  
  METHODS
  The results of our first 64 patients who underwent SRGB with a 5.5 cm ring have been reviewed with particular attention to weight loss, short- and medium-term morbidity and patient satisfaction. Most patients have had regular follow-up, and those not seen during the last 6 months were sent a postal questionnaire.
  
  
  RESULTS
  The patients included 52 females and 12 males, ranging in age from 23 to 59 years (median age=39 years) at the time of surgery. Median preoperative weight, body mass index (BMI) and % excess weight were 126 kg (range 89-253 kg), 44 kg/m2 (range 36-78 kg/m2) and 113 (range 76-209) respectively. There were no serious postoperative complications and no deaths. Median hospital stay was 7 days (range 5-14 days). Eight patients (13%) are known to have had a staple-line dihiscence. Eighteen patients (28%) have had major difficulties with eating, and in nine (14%) of these the silastic ring has been removed with resolution of the eating problems, but some gain in weight. In the 54 patients with follow-up data at 2 years, median weight was 78 kg (range 55-137 kg), median BMI was 27 kg/m2 (range 20-43 kg/m2) and mean +/- SD % excess weight loss was 69+/-16. After 2 years of follow-up, eight of 54 patients (15%) were unhappy with the results of the procedure.
  
  
  CONCLUSIONS
  SRGB is an effective, safe and well-tolerated procedure for achieving weight loss in the morbidly obese. The principal drawbacks relate to staple-line problems and eating difficulties related to the silastic ring. A 5.5 cm ring is probably too small to be ideal.
authors.affiliation: Wakefield Gastroenterology Centre, Wakefield Hospital, Wellington, New Zealand.
authors.forename: N A
authors.initials: NA
authors.lastname: Crampton
authors.forename: V
authors.initials: V
authors.lastname: Izvornikov
authors.forename: R S
authors.initials: RS
authors.lastname: Stubbs
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D015992:Body Mass Index; D001835:Body Weight; D004867:Equipment Design; D001068:Feeding and Eating Disorders / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D015391:Gastroplasty; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D012826:Silicone Elastomers; D017792:Surgical Stapling / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000209:etiology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D012826:Silicone Elastomers