Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up.
BACKGROUND
The authors have performed the laparoscopic gastric bypass since 1993 and perform about one-half of bariatric cases laparoscopically. Since our initial report, several groups throughout the world have preformed the gastric bypass laparoscopically, with various modifications.


METHODS
Prospectively, we followed and recorded the results of our laparoscopic patients. A detailed pre- and post-operative analysis of the patient's co-morbidities is performed as well as complete weight and laboratory data evaluation.


RESULTS
With > 80% follow-up, we found an excess weight loss of about 80% by the first year. This degree of loss is well sustained. Over 95% of the significant pre-operative co-morbidities are controlled.


CONCLUSIONS
The laparoscopic gastric bypass has been refined over 5 years of use. Though we have not changed the basic operation as we originally described, others have modified the various anastomotic techniques. The weight loss results are very good to excellent, with patients now out to "long-term" follow-up. Resolution of the co-morbidities is documented. The operation has an adequate track record to show effectiveness, and training programs should be established to maximize safety.
Private Practice, Alvarado Hospital and Medical Center, San Diego, CA, USA. acwmd@gastricbypass.com
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Wittgrove
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Clark
D000713:Anastomosis, Roux-en-Y; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D005774:Gastrostomy; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000601:surgery; D011183:Postoperative Complications; D011446:Prospective Studies; D015431:Weight Loss