| Utility of divided omentum for preventing complications associated with laparoscopic gastric bypass. | |
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MedLine Citation:
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PMID: 18060469 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Laparoscopic Roux-en-Y gastric bypass has emerged as a standard surgical treatment for morbid obesity. However, prevention of postoperative complications associated with bariatric surgery is an important consideration. METHODS: To reduce postoperative complications and achieve adequate body weight loss, we introduce a simple procedure using a divided omentum during laparoscopic Roux-en-Y gastric bypass. The actual aim of this procedure is to prevent leakage from the gastric pouch or anastomosis and the gastro-gastric fistula because of reentry of the alimentary tract. Between February 2002 and April 2007, we performed laparoscopic Roux-en-Y gastric bypass for morbid obesity in 94 patients. In the most recent 83 cases, our simple procedure using a divided omentum was employed. RESULTS: These patients comprised 20 males and 63 females, with a mean age of 38 years, and a mean body mass index of 44.1 kg/m(2). At surgery, the omentum is routinely divided using laparoscopic coagulating shears before performing gastrojejunostomy to reduce the tension on the anastomosis caused by the route of reconstruction. After performing hand-sewn gastrojejunostomy, the left side of the divided omentum is moved cranially and interposed between the gastric pouch and the excluded stomach. The omentum is then sutured from the posterior aspect of the gastric pouch to the anterior side of the anastomosis. CONCLUSION: Our procedure using a divided omentum during bariatric surgery is feasible and safe for obtaining better outcomes without artificial materials. Although the long-term outcome of this technique is still unclear, we believe that it will contribute to decreasing the particular complications related to laparoscopic Roux-en-Y gastric bypass for morbid obesity. |
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Authors:
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Nobumi Tagaya; Kazunori Kasama; Eiji Kanahira; Keiichi Kubota |
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Publication Detail:
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Type: Journal Article Date: 2007-11-30 |
Journal Detail:
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Title: Obesity surgery Volume: 17 ISSN: 0960-8923 ISO Abbreviation: Obes Surg Publication Date: 2007 Dec |
Date Detail:
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Created Date: 2007-12-24 Completed Date: 2008-04-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9106714 Medline TA: Obes Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1567-70 Citation Subset: IM |
Affiliation:
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Second Department of Surgery, Dokkyo Medical University, 880 Kitakobayashi, Mibu, Tochigi 321-0293, Japan. tagaya@dokkyomed.ac.jp |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Anastomosis, Roux-en-Y / methods Body Mass Index Female Gastric Bypass / methods* Humans Laparoscopy / methods Male Middle Aged Obesity, Morbid / surgery* Omentum / surgery* Postoperative Complications / prevention & control* Suture Techniques |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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