title: Mini-gastric bypass by mini-laparotomy: a cost-effective alternative in the laparoscopic era.
abstract: BACKGROUND
  Laparoscopic mini-gastric bypass (MGB) is being increasingly performed worldwide. Results of MGB by mini-laparotomy (minilap MGB) are hereby reported.
  
  
  METHODS
  126 patients undergoing minilap MGB from October 2004 to October 2006, were reviewed at an academic institution.
  
  
  RESULTS
  Mean age was 35 +/- 11.4 years (range 15-72), preoperative BMI was 44 +/- 6.9 kg/m2 (range 35-61.8) and 80 (63.4%) were women. Co-morbidities were present in 42 (33.3%). Operative time was 144 +/- 15.8 minutes (range 120-160) and length of hospital stay was 3.32 +/- 0.62 days (range 2-18). There was no hospital mortality, and the in-hospital complication rate was 4.7%. No anastomotic leakage occurred, and the incidence of wound sepsis was 2.3%. The mean total cost of the procedure was 3408 +/- 547 USD (range 2967-6876). Five patients (3.9%) developed incisional hernias and 3 (2.3%) marginal ulcers. BMI at 6 months was 33.0 +/- 3.1 kg/m2 (range 26.8-43.5, P < 0.001) compared with preoperative value. At 1 year, mean excess weight loss was 68.4% and comorbidities resolved in 85%.
  
  
  CONCLUSIONS
  Minilap MGB is a simple, safe, effective and low-cost gastric bypass. It represents an attractive cost-effective alternative to laparoscopic MGB.
authors.affiliation: Department of Digestive Surgery, Hôtel-Dieu de France Hospital, Beirut, Lebanon. rnoun@wise.net.lb
authors.forename: Roger
authors.initials: R
authors.lastname: Noun
authors.forename: Eddy
authors.initials: E
authors.lastname: Riachi
authors.forename: Smart
authors.initials: S
authors.lastname: Zeidan
authors.forename: Bassam
authors.initials: B
authors.lastname: Abboud
authors.forename: Viviane
authors.initials: V
authors.lastname: Chalhoub
authors.forename: Alexandre
authors.initials: A
authors.lastname: Yazigi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D015390:Gastric Bypass / Q000191:economics* / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D007813:Laparotomy / Q000191:economics* / Q000379:methods*; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D016896:Treatment Outcome