Evolution of minimally invasive bariatric surgery

Jon C. Gould, Bradley J. Needleman, E. Christopher Ellison, Peter Muscarella, Carol Schneider, W. Scott Melvin

Research output: Contribution to journalArticle

46 Citations (Scopus)

Abstract

Background. Minimally invasive Roux-en-Y gastric bypass is a procedure that is being performed with increasing frequency. It is an advanced laparoscopic procedure with a steep learning curve. With experience, it can be performed in a reasonable amount of time with minimal morbidity. Methods. We first performed minimally invasive gastric bypass with the hand-assisted laparoscopic surgery (HALS) technique. After significant experience with HALS, we changed our approach to completely laparoscopic (LS). Our technique for all cases involves a circular stapled gastrojejunostomy with a 25-mm anvil passed transgastrically. Results. From June 1998 to January 2002, 304 patients underwent minimally invasive gastric bypass. Our first 81 cases were with HALS, and the rest were LS. The incidence of early major and minor peri-operative complications for the entire series was 5.6% and 7.9%, respectively. Early reoperation (less than 30 days) was required in 4.6% of all patients. There was 1 leak (1.2%) in the HALS group and 4 anastomotic leaks (1.8%) in the LS group. Other measured outcomes were similar in each group with the exception of wound hernia (16% HALS vs 0.9% LS). Weight loss after 1 year was 44% for HALS and 56% for LS. We have not had any deaths in our series. Conclusions. HALS may have certain advantages in selected patients and early in a surgeon's experience with minimally invasive gastric bypass. With experience, good results are possible with either approach.

Original languageEnglish (US)
Pages (from-to)565-572
Number of pages8
JournalSurgery
Volume132
Issue number4
DOIs
StatePublished - Oct 1 2002
Externally publishedYes

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Hand-Assisted Laparoscopy
Bariatric Surgery
Minimally Invasive Surgical Procedures
Gastric Bypass
Anastomotic Leak
Learning Curve
Hernia
Reoperation
Weight Loss
Morbidity

ASJC Scopus subject areas

  • Surgery

Cite this

Gould, J. C., Needleman, B. J., Ellison, E. C., Muscarella, P., Schneider, C., & Melvin, W. S. (2002). Evolution of minimally invasive bariatric surgery. Surgery, 132(4), 565-572. https://doi.org/10.1067/msy.2002.127554

Evolution of minimally invasive bariatric surgery. / Gould, Jon C.; Needleman, Bradley J.; Ellison, E. Christopher; Muscarella, Peter; Schneider, Carol; Melvin, W. Scott.

In: Surgery, Vol. 132, No. 4, 01.10.2002, p. 565-572.

Research output: Contribution to journalArticle

Gould, JC, Needleman, BJ, Ellison, EC, Muscarella, P, Schneider, C & Melvin, WS 2002, 'Evolution of minimally invasive bariatric surgery', Surgery, vol. 132, no. 4, pp. 565-572. https://doi.org/10.1067/msy.2002.127554
Gould JC, Needleman BJ, Ellison EC, Muscarella P, Schneider C, Melvin WS. Evolution of minimally invasive bariatric surgery. Surgery. 2002 Oct 1;132(4):565-572. https://doi.org/10.1067/msy.2002.127554
Gould, Jon C. ; Needleman, Bradley J. ; Ellison, E. Christopher ; Muscarella, Peter ; Schneider, Carol ; Melvin, W. Scott. / Evolution of minimally invasive bariatric surgery. In: Surgery. 2002 ; Vol. 132, No. 4. pp. 565-572.
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