title: Laparoscopic jejunal sleeve: a simple and ideal new technique for revision of Roux-en-Y gastric bypass after weight regains technical aspects.
abstract: Revision of gastric bypasses that fail is one of the most difficult challenges that face bariatric surgeons these days. Adding a foreign body like a band or a silastic may give unsatisfactory results, while increasing malabsorption may result in severe malnutrition and hypoproteinemia. Laparoscopic jejunal sleeve is based on the principles of laparoscopic sleeve gastrectomy applied to a failed Roux-en-Y gastric bypass. The procedure is simple and involves only stapling, is reproducible, accessible, effective, and safe, without foreign bodies. Weight loss may be achieved to give an extra 5 to 10 points of BMI reduction. Early complications are similar to laparoscopic sleeve gastrectomy and may involve leaks and strictures. Mid- and long-term weight loss data are lacking at the present time, and patients should be selected based on an initial response to their gastric bypass.
authors.affiliation: Department of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
mesh_terms: D000328:Adult; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D009765:Obesity / Q000601:surgery*; D012086:Reoperation / Q000379:methods; D013537:Sutures; D017211:Treatment Failure