The Magenstrasse and Mill operation for morbid obesity.
BACKGROUND
Our aim was to evolve a simpler, more physiological type of gastroplasty that would dispense with implanted foreign material such as bands and reservoirs. The Magenstrasse, or "street of the stomach", is a long narrow tube fashioned from the lesser curvature, which conveys food from the esophagus to the antral Mill. Normal antral grinding of solid food and antro-pyloro-duodenal regulation of gastric emptying and secretion are preserved.


METHODS
100 patients with morbid obesity (83M, 17F, mean age 40 years) were treated by the Magenstrasse and Mill procedure and followed-up for 1-5 years. Mean preoperative BMI was 46.3 kg/m2, and mean excess weight was 106%.


RESULTS
Operative mortality was 0. Major complications occurred in 4% of patients. There were few side-effects, although mild heartburn was fairly common. Mean weight loss was 38 kg (+/- 14 kg), equivalent to 60% of excess weight, achieved within 1 year of operation, after which no further significant gain or loss of weight occurred.


CONCLUSIONS
The Magenstrasse and Mill procedure is the simplest and most physiological gastroplasty yet described. Many of the drawbacks of vertical banded gastroplasty, adjustable banding and gastric bypass are avoided. It is safe, has few side-effects and leads to major and durable weight losses, similar to those produced by other types of gastroplasty.
Johnston
David
D
The Academic Department of Surgery, Leeds General Infirmary and the University of Leeds, Leeds, England, UK. david@medisoft.co.uk
Dachtler
Jenny
J
Sue-Ling
Henry M
HM
King
Roderick F G J
RF
Martin
lain G
lG
D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D015391:Gastroplasty / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011184:Postoperative Period; D012189:Retrospective Studies; D016896:Treatment Outcome