title: Laparoscopic Silastic Ring Mini-Gastric Bypass (SR-MGBP): Up to 11-Year Results from a Single Centre.
abstract: Bariatric surgery is well established as an effective method for treating obesity and its related comorbidities. The laparoscopic mini-gastric bypass (MGBP) represents a simpler alternative to a Roux-en-Y gastric bypass (RYGBP). The placement of a silastic ring (SR) may enhance excess weight loss and minimize weight regain. This study reports long-term results from a cohort of patients undergoing a SR-MGBP in a single centre.
  
  
  
  Long-term outcomes (up to 11 years) in a cohort of 156 patients undergoing surgery between August 2005 and January 2008 were analysed. A combination of follow-up questionnaires and electronic hospital records were used to assess weight loss, comorbidity resolution and complications.
  
  
  
  A total of 156 patients (mean body mass index 46 kg/m2) underwent surgery. Ninety-two patients responded to the follow-up questionnaires. Computer-based hospital information was available on a total of 139 patients. Mean percent excess weight loss (%EWL) at 11 years was 84.3%. Comorbidity resolution, determined by medication use, showed a reduction in diabetes (21.8% to 7.1%), hypertension (37.2% to 21.4%) and hypercholesterolaemia (40.4% to 13.4%). Five of 139 patients (3.6%) had SR problems needing removal. Two other patients had the SR changed to a bigger size and a further two had endoscopic removal of the SR for erosion. Of the 139 patients, 9.4% required conversion to a Roux-en-Y gastric bypass (RYGBP). The number of patients on anti-reflux medications increased from 5.1% to 44.6% at 11 years. There were two deaths unrelated to surgery.
  
  
  
  SR-MGBP appears to be a safe and effective operation for the morbidly obese. It is durable, with good weight loss at up to 11 years post-surgery. The SR can easily be removed or exchanged for another size and is reasonable to consider when performing a MGBP. Concerns about bile reflux appear to be well founded, and some patients who are poorly controlled medically will require revision.
authors.affiliation: Department of Surgery North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland, New Zealand. lailasheikh@gmail.com.
authors.forename: Laila
authors.identifier: 0000-0002-3249-1145
authors.initials: L
authors.lastname: Sheikh
authors.affiliation: Waitemata Specialist Centre, 13-15 Shea terrace, Takapuna, Auckland, New Zealand.
authors.forename: Lyn A
authors.initials: LA
authors.lastname: Pearless
authors.affiliation: Department of Surgery North Shore Hospital, 124 Shakespeare Road, Takapuna, Auckland, New Zealand.|Waitemata Specialist Centre, 13-15 Shea terrace, Takapuna, Auckland, New Zealand.
authors.forename: Michael Wc
authors.initials: MW
authors.lastname: Booth
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D004129:Dimethylpolysiloxanes / Q000627:therapeutic use*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D015431:Weight Loss; D055815:Young Adult
chemical_list: D004129:Dimethylpolysiloxanes; C013830:baysilon
keywords: Bariatric surgery; Excess weight loss; Gastric bypass; Mini-gastric bypass; Silastic ring