Laparoscopic-assisted Roux-en-Y gastric bypass

Eight patients underwent laparoscopic Roux-en-Y gastric bypass from May 199 8 to September 1998 in which a hand-assist technique was used. The operatio n consisted of a 7.5-cm periumbilical midline incision along with three tro cars placed in the upper abdomen, The operative times ranged from 2.25 to 4 .5 h, The average preoperative body mass index was 44 kg/m.(2) Three-month postoperative follow-up revealed an average weight loss of 59 Ib, Cosmetic results to date have been excellent even when compared with those of a tota l laparoscopic operation. The hand-assist technique allows the surgeon to h ave more control over the most difficult part of the case, which is manipul ation of the small bowel in a morbidly obese abdomen.