title: Laparoscopic Roux-en-Y gastric bypass in the "megaobese".
abstract: OBJECTIVE
  Laparoscopic Roux-en-Y gastric bypass is a safe and effective procedure in patients with a body mass index (BMI; calculated as weight in kilograms divided by the square of height in meters) of 70 or greater.
  
  
  METHODS
  A retrospective analysis of patients with a BMI of 70 or greater who underwent laparoscopic Roux-en-Y gastric bypass by a single surgeon.
  
  
  METHODS
  A university-affiliated community hospital in Allentown, Pa.
  
  
  METHODS
  A nonconsecutive series of 9 patients with a BMI of 70 or greater who met traditional criteria for a bariatric procedure.
  
  
  METHODS
  Laparoscopic approach to Roux-en-Y gastric bypass with stapled anastomoses.
  
  
  RESULTS
  Patient medical records were reviewed for length of stay, complications, operative time, comorbidities, and weight loss. Seven patients were women and 2 were men. Comorbidities included dyspnea on exertion, peripheral edema, arthritis, sleep apnea, hypertension, diabetes mellitus, asthma, hypothyroidism, gastroesophageal reflux disease, peptic ulcer disease, and heart disease. Eight of 9 procedures were successfully completed laparoscopically. One patient was converted to an open procedure. One patient developed a marginal ulcer postoperatively. No other complications occurred. Operative time ranged from 122 to 330 minutes (mean, 203 minutes). Length of stay averaged 1.2 days. Overall weight loss was 49% of excess body weight at 1 year after surgery.
  
  
  CONCLUSIONS
  Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI of 70 or greater.
authors.affiliation: Department of Surgery, Lehigh Valley Hospital, Allentown, PA, USA.
authors.forename: Keith
authors.initials: K
authors.lastname: Kreitz
authors.forename: Peter F
authors.initials: PF
authors.lastname: Rovito
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D015992:Body Mass Index; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D013537:Sutures; D016896:Treatment Outcome; D015431:Weight Loss