Laparoscopic Roux-en-Y vs. Mini-gastric Bypass for Obesity

In the most recent issue of Annals of Surgery researchers show that laparoscopic mini-gastric bypass is a simpler and safer procedure that has no disadvantage compared with laparoscopic Roux-en-Y gastric bypass.

Researchers conducted a prospective, randomized trial to compare treatments of morbid obesity. The team compared the safety and effectiveness of laparoscopic Roux-en-Y gastric bypass and laparoscopic mini-gastric bypass in the treatment of morbid obesity.
Laparoscopic Roux-en-Y gastric bypass has been the gold standard for the treatment of morbid obesity. While laparoscopic mini-gastric bypass has been reported to be a simple and effective treatment, the team report that data from a randomized trial are lacking. The researchers recruited 80 patients who met the National Institute of Health criteria and randomized 40 patients to receive laparoscopic Roux-en-Y gastric bypass and 40 to laparoscopic mini-gastric bypass. The research team reported that the minimum postoperative follow-up was two years and that perioperative data were assessed. The researchers determined late complication, excess weight loss, body mass index, quality of life, and comorbidities. Changes in quality of life were assessed using the Gastro-Intestinal Quality of Life Index.

The researchers found one conversion in the laparoscopic Roux-en-Y gastric bypass group. Operation time was shorter in laparoscopic mini-gastric bypass group and there was no mortality in either group. The team observed that the operative morbidity rate was higher in the laparoscopic Roux-en-Y gastric bypass group, at 20 percent versus 8 percent. The late complications rate was the same in the two groups at 8 percent with no re-operation. The team noted that weight loss was 59 percent and 60 percent at one and two years, respectively, in the laparoscopic Roux-en-Y gastric bypass group. The team noted that percentage weight loss in the group was 65 percent and 64 percent in the laparoscopic mini-gastric bypass group. Residual excess weight of less than 50 percent at two years postoperatively was achieved in 75 percent of patients in the laparoscopic Roux-en-Y gastric bypass group. In comparison, the researchers found that residual excess weight loss at two years in the laparoscopic mini-gastric bypass group was 95 percent. A significant improvement of obesity-related clinical parameters and complete resolution of metabolic syndrome in both groups were noted. In addition, the researchers observed that gastrointestinal quality of life increased significantly without any significant difference between the groups.

Annals of Surgery; 2005: 242(1): 20-8

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Warning: Gastric Bypass Surgery is a MAJOR surgical procedure. It can be associated with significant risks and complications, up to and including death. Weight loss surgery is a rapidly developing area of medicine. Bariatric surgery is filled with controversy. It is very important to take a careful and deliberate approach to considering surgery for the treatment of obesity.  

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