Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity

Objective To evaluate the short-term outcomes for laparoscopic Roux-en-Y ga stric bypass in 275 patients with a follow-up of 1 to 31 months. Summary Background Data The Roux-en-Y gastric bypass is a highly successful approach to morbid obesity but results in significant perioperative compli cations. A laparoscopic approach has significant potential to reduce periop erative complications and recovery time. Methods Consecutive patients (n = 275) who met NIH criteria for bariatric s urgery were offered laparoscopic Roux-en-Y gastric bypass between July 1997 and March 2000. A 15-mL gastric pouch and a 75-cm Roux limb (150 cm for su perobese) was created using five or six trocar incisions. Results The conversion rate to open gastric bypass was 1%. The start of an oral diet began a mean of 1.58 days after surgery, with a median hospital s tay of 2 days and return to work at 21 days. The incidence of early major a nd minor complications was 3.3% and 27%, respectively. One death occurred r elated to a pulmonary embolus (0.4%). The hernia rate was 0.7%, and wound i nfections requiring outpatient drainage only were uncommon (5%), Excess wei ght loss at 24 and 30 months was 83% and 77%, respectively. In patients wit h more than 1 year of follow-up, most of the comorbidities were improved or resolved, and 95% reported significant improvement in quality of life. Conclusion Laparoscopic Roux-en-Y gastric bypass is effective in achieving weight loss and in improving comorbidities and quality of life while reduci ng recovery time and perioperative complications.