TITLE:
Gastric Bypass with Long Pouch and Transit Bipartition for Endoscopic Access to the Remaining Stomach
AUTHORS:
Paulo Reis Esselin de Melo, Marcella Giovana Gava-Brandolis, Thonya Cruz Braga, Danilo Fossalussa Minari, Ricardo Augusto Martins Bueno da Costa, Jose Geraldo Moraes Sampaio Neto, Louise Flores Silva, José Humberto Cardoso Resende
KEYWORDS:
Obesity, Bariatric Surgery, Metabolic Surgery, Roux-En-Y Gastric Bypass
JOURNAL NAME:
Surgical Science,
Vol.13 No.8,
August
9,
2022
ABSTRACT: Introduction: obesity has a complex and multifactorial etiology, difficult treatment
and increasing incidence rates in recent decades. The treatment involves
clinical and pharmacological approaches and, in case of lack of results,
surgical interventions. Roux-en-Y gastric bypass (RYGB) is one of these
surgical interventions in which the stomach is divided, creating a small pouch,
and the remaining portion of the stomach become excluded and left without
endoscopic access. Objective: to evaluate the results of modified RYGB
with long
pouch and endoscopic access to the remaining stomach. Materials and Methods: prospective clinical trial with sample selected among patients seen at the
Alberto Rassi General State Hospital of Goiânia (HGG) and indicated for
bariatric and metabolic surgery confirmed by the medical and multidisciplinary
team. The study was conducted from January 2020 to August 2021. Clinical
history and laboratory test results of the selected patients were collected
through consultations with the medical and multidisciplinary team. Results: twelve
participants were included in the study. Of these, 11 (91.7%) were women and
the mean age was 46.3 years. The weight before surgery was 112.17 kg (92.00 - 150.00) and the Body Mass
Index (BMI) was 44.89 (35.06 - 74.39). After 18 months of surgery, the mean weight was 80.77 kg (±11.92) and
the mean BMI was 29.46 (±11.00), showing a significant reduction in both (p = 0.003
and p = 0.002, respectively). All patients underwent endoscopic evaluation of
the pouch, remaining stomach and duodenum at 12 months postoperatively. The
mean percentage of lost excess weight loss was 68.21%. Conclusion: We
conclude that the proposed changes in RYGB (GBLP + GIB – Roux-en-Y gastric
bypass with long pouch and gastrointestinal bipartition) did not compromise
weight loss or control of type 2 diabetes and other comorbidities and proved to
be a safe and effective alternative without gastroduodenal exclusion, enabling
a better postoperative follow-up.