An analysis of gastric pouch anatomy in bariatric surgery.
BACKGROUND
The goal of most bariatric surgeons has been to construct small volume pouches in the proximal stomach to restrict the intake of food. The purpose of this study is to demonstrate that in addition to pouch volume, specific gastric pouch anatomy plays a significant role in weight loss.


METHODS
The physical properties and dynamics of the pouch in our form of gastric bypass were compared with those in the most commonly performed bariatric procedures by creating a model. Our weight loss data were reviewed and compared with data reported in the literature.


RESULTS
According to LaPlace's and Poiseulle's Laws, a long narrow cylinder will have less wall tension and slower flow rate of material than a wider cylinder. Bariatric procedures with narrow pouches appear to produce better weight loss.


CONCLUSIONS
Long narrow pouches should have less tendency to enlarge and should delay the transit of material to a greater degree than wider pouches according to the LaPlace's and Poiseuille's Laws. Our data and the data of others strongly suggest that long narrow pouches are the most effective operations in bariatric surgery.
Capella
Rafael F
RF
Department of Surgery, Hackensack University Medical Center, Hackensack, NJ, USA. rcapella@capellasurgery.net
Iannace
Vincent A
VA
Capella
Joseph F
JF
D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D015390:Gastric Bypass / Q000295:instrumentation / Q000379:methods*; D005769:Gastrointestinal Motility / Q000502:physiology*; D015391:Gastroplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007408:Intestinal Absorption; D008875:Middle Aged; D008954:Models, Biological; D009767:Obesity, Morbid / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology* / Q000503:physiopathology; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult