Functional gastric bypass with an adjustable gastric band.
BACKGROUND
To create a bond between the technique proposed and the patient, flexibility and adaptability are indispensable. Thus, we devised the functional gastric bypass, which can be activated and deactivated by inflating or deflating the Lap-Band.


METHODS
The Lap-Band was positioned according to the standard technique, with the addition of a hand-sewn side-to-side gastroenterostomy between the gastric pouch and the intestine in the form of an Omega loop. Inflation or deflation of the Lap-Band allows activation or deactivation of the bypass. From October 1995 to December 2001, 545 Lap-Band operations were carried out. Between January 2001 and December 2001, functional gastric bypass was performed on 7 patients. Indications were: 1) prior failed Lap-Band treatment; 2) the first-choice operation for patients where non-restrictive surgery may be indicated.


RESULTS
There was no morbidity or mortality. The functioning bypass was confirmed radiologically and clinically.


CONCLUSIONS
In morbid obesity characterized by a variable relationship with food, the flexibility of the functional bypass allows adaptation to changes in the pathology itself and in the individual patient, which other surgical techniques cannot do. Surgical indications, proven feasibility, safety and efficacy await long-term documentation.
Furbetta
Francesco
F
Ospedale di Pescia, Pescia (PT), Italy. dascanio@dfb.unipi.it
Gambinotti
Giancarlo
G
D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D012086:Reoperation