The 'Hug' Technique—Roux-en-Y Gastric Bypass with Preservation of the Posterior Wrap in Patients with Previous Nissen Fundoplication: a Simple Solution for a Complex Problem
| Autor: | João Caetano Marchesini, Ricardo Zorron, Christian Benzing, Wagner Herbert Sobottka, Jose Alfredo Sadowski, João Batista Marchesini, Claudia Bures |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric bypass Gastric Bypass Fundoplication 030209 endocrinology & metabolism Nissen fundoplication 03 medical and health sciences 0302 clinical medicine Weight loss medicine Humans In patient Prospective Studies Retrospective Studies Nutrition and Dietetics business.industry Stomach Roux-en-Y anastomosis Obesity Morbid Surgery Dissection Treatment Outcome medicine.anatomical_structure Gastroesophageal Reflux Laparoscopy 030211 gastroenterology & hepatology medicine.symptom business Body mass index |
| Zdroj: | Obesity Surgery. 30:4325-4330 |
| ISSN: | 1708-0428 0960-8923 |
| Popis: | Laparoscopic conversion of Nissen Fundoplication to Roux-en-Y gastric bypass (RYGB) is a complex procedure due to increased operative time, morbidity, and length of hospital stay (LOS). In this study, a new simplified technique avoiding the total dismantling of the previous Nissen repair to construct the gastric pouch, the so-called hug technique is presented for the conversion of Nissen fundoplication to RYGB. The present study is a prospective single-center clinical series reporting on the feasibility and safety of the “hug” technique for the creation of laparoscopic RYGB. The major innovation of this approach is the fact that the posterior part of the fundoplication wrap is left in place without further dissection or manipulation. The anterior part is stapled and remains attached to the excluded stomach. Prospective data on intraoperative and postoperative morbidity and bariatric outcomes were collected. A total of 44 consecutive patients with a mean body mass index (BMI) of 43.7 kg/m2 (SD = 4.0, range = 35.6–52.0) underwent the “hug” procedure between 2004 and 2015. Mean operative time was 72 min (58–105 min). Morbidity was 4.5%, with no mortality. For patients with follow-up at 3 years, the percentage of total body weight loss (%TBWL) was 32.5%; the excess weight loss (EWL) was 64.2%. In contrast to current other techniques of bariatric surgery for patients having previously undergone a Nissen fundoplication, the “hug” procedure to create an RYGB is safe and simple to perform. This technique avoids the deconstruction of the previous repair and is still maintaining anti-reflux anatomy. Nevertheless, there is a need for further studies to evaluate the long-term outcomes of the procedure. |
| Databáze: | OpenAIRE |
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