A Simple Technique of Gastric Pouch Resizing for Inadequate Weight Loss After Roux-en-Y Gastric Bypass

Oct 27, 2016Obesity surgery

An Easy Method to Resize the Stomach Pouch for Poor Weight Loss After Gastric Bypass Surgery

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗

Abstract

Weight regain after Roux-en-Y gastric bypass (RYGB) can be significant, with one case reporting a BMI increase from 38 kg/m² to 44 kg/m².

Laparoscopic resizing of the gastric pouch may be necessary due to weight regain after initial RYGB.
A case presented involved a 42-year-old woman with a pouch volume of 220 cm³ and an anastomosis diameter of 20 mm.
Severe adhesions between the gastric pouch and residual stomach can complicate dissection during revisional surgery.
A technique of en bloc resection of the gastric pouch and residual stomach is proposed to simplify the surgical process.
This method is suggested for use in situations where identifying a cleavage plane is challenging.

AI simplified

INTRODUCTION: Weight regain after Roux-en-Y gastric bypass (RYGB) is increasingly reported in the literature Debs et al. Surg Obes Relat Dis (2016). Laparoscopic resizing of the gastric pouch and the gastrojejunal anastomosis is an accepted surgical option Nguyen et al. (Obes Surg 25:928-34, 2015); Iannelli et al. (Surg Obes Relat Dis 9:260-7, 2013); Al-Bader et al. (Obes Surg 25:1103-8, 2015). The aim of this video is to present a simple technique of en bloc resection.

METHODS: We present the case of a 42-year-old woman with a BMI of 44 kg/mwho underwent laparoscopic RYGB in 2007. In 2015, she regained weight till reaching a BMI of 38 kg/m. 3D CT volumetry was performed that showed a pouch volume of 220 cmand a gastrojejunal anastomosis diameter of 20 mm. 2 2 3

RESULTS: There are often a lot of adherences between the gastric pouch and the residual stomach, which makes the dissection difficult and tedious, with the possibility to devascularize the residual stomach and lead to a gastric fistula from this residual stomach. We present in this video a simple technique of gastric pouch resizing that consists of en bloc resection of the gastric pouch, the residual stomach, and ± the gastrojejunal anastomosis. We recommend this technique in case of severe adherences and inability to identify a cleavage plane between the excess gastric pouch and the resected stomach.

CONCLUSION: Insufficient weight loss or weight regain after RYGBP is becoming more frequently encountered. As a result, revisional surgery will be more frequently performed. This simple technique allows an easier dissection across healthier tissues and is easier to perform in the presence of severe adherences between the gastric pouch and the residual stomach.

Full Text

Full text is available at the source.

View full text (PDF) ↗View full text (HTML) ↗

A Simple Technique of Gastric Pouch Resizing for Inadequate Weight Loss After Roux-en-Y Gastric Bypass

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief