title: The future of the Roux-en-Y gastric bypass.
abstract: Archaic surgical procedures such as the jejunoileal bypass, vertical banded gastroplasty and duodenal switch have contributed to the current best practice of Roux-en-Y gastric bypass (RYGB) procedure for the treatment of obesity and its consequences. Despite this, RYGB has been blighted with late occurring adverse events such as severe malnutrition, marginal ulcer and reactive hypoglycemia. Despite this, RYGB has given us an opportunity to examine the effect of surgery on gut hormones and the impact on metabolic syndrome which in turn has allowed us to carry out a lower impact but equally, if not more effective, procedure - the vertical sleeve gastrectomy (VSG). We examine the benefits of sleeve gastrectomy from the less challenging technical aspect to the effect on obesity and its metabolic syndrome long-term and have concluded that sleeve gastrectomy is possibly the next current best practice.
authors.affiliation: a Division of Minimally Invasive Gastrointestinal Surgery and Medicine, Department of Surgery , University of Minnesota Medical Center , Minneapolis , MN , USA.
authors.forename: Chin Hong
authors.initials: CH
authors.lastname: Lim
authors.affiliation: a Division of Minimally Invasive Gastrointestinal Surgery and Medicine, Department of Surgery , University of Minnesota Medical Center , Minneapolis , MN , USA.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Jahansouz
authors.affiliation: a Division of Minimally Invasive Gastrointestinal Surgery and Medicine, Department of Surgery , University of Minnesota Medical Center , Minneapolis , MN , USA.
authors.forename: Anasooya A
authors.initials: AA
authors.lastname: Abraham
authors.affiliation: a Division of Minimally Invasive Gastrointestinal Surgery and Medicine, Department of Surgery , University of Minnesota Medical Center , Minneapolis , MN , USA.
authors.forename: Daniel B
authors.initials: DB
authors.lastname: Leslie
authors.affiliation: a Division of Minimally Invasive Gastrointestinal Surgery and Medicine, Department of Surgery , University of Minnesota Medical Center , Minneapolis , MN , USA.
authors.forename: Sayeed
authors.initials: S
authors.lastname: Ikramuddin
mesh_terms: D003362:Cost-Benefit Analysis; D005544:Forecasting; D005743:Gastrectomy / Q000009:adverse effects / Q000191:economics / Q000639:trends*; D015390:Gastric Bypass / Q000009:adverse effects / Q000191:economics / Q000639:trends*; D017048:Health Care Costs; D006801:Humans; D009767:Obesity, Morbid / Q000175:diagnosis / Q000191:economics / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Roux-en-Y gastric bypass; body mass index; morbid obesity; obesity; surgical weight loss