Whichever technique is used to construct the gastrojejunostomy, LRYGBP is a safe, effective and technically feasible operation for morbidly obese patients. We recommend the technique of constructing the gastrojejunostomy with an endocutter cartridge and closing the anastomotic incision with an endo TA stapler, as it saved time and reduced the incidence of the essential complications in gastric bypass surgery.

Background: Restrictive bariatric procedures are commonly performed to induce weight reduction, however, some patients may require a second surgery due to inadequate weight loss, weight regain or late complications. Laparoscopic mini gastric bypass (LMGB) is a promising bariatric procedure, which provides an effective long-term weight loss and resolution of primary procedure related complications. Aim of the Work: To assess laparoscopic Mini Gastric Bypass as a bariatric surgical technique for revision after failed primary restrictive bariatric procedure. Cause of revision, weight loss, resolution of primary procedure related co-morbidities and complication rates will be assessed. Patients and Methods: This study included 60 patients with failed primary restrictive bariatric procedures (20 patients with failed sleeve gastrectomy, 20 patients with failed vertical banded gastroplasty and 20 patients with failed adjustable gastric banding) that were converted to laparoscopic MGB with minimal follow-up of 1 year. Results: Among all patient samples (60 patients) , there was significant decrease in mean body mass index after conversion to MGB. The mean BMI before revision was 42.80 ± 3.43 kg/m2 (range, 36-48.9) that decreased to 32.51 ± 3.31 kg/m2 one year after revision. A significant improvement of obesity related co-morbidities was observed after one year, the incidence of remission of diabetes mellitus was 91.6%, while it was 64.7% for hypertension and it was 70.5% for dyslipidemia. Reflux symptoms improved in about 80% of affected cases. Complications occurred only in 5% of cases and they were successfully managed. Conclusion: Mini gastric bypass is a safe and effective revisional procedure after failed primary restrictive bariatric surgery that adequate weight loss and satisfactory improvement of the primary procedure related complications.

Background groin hernia repair is considered to be one of the most commonly performed operations by general surgeons however; there is no “gold standard” operation for treatment of inguinal hernias. The optimal surgical approach must be selected individually for the patient, taking into account patient age, hernia size, unilaterality or bilaterality, primary or recurrent status, and type of anesthesia, occupation, and leisure activities. Aim of the Work is to compare the outcome results of the laparoscopic total extraperitoneal TEP hernia repair with mesh or the transabdominal preperitoneal repair (TAPP) with mesh to those of open repair with mesh. Patients and Methods this is a prospective study conducted on those who are diagnosed to have inguinal hernia (direct, indirect). 40 cases with direct, indirect, unilateral or bilateral inguinal hernia and will be divided into two groups: Group A 20 cases fixation a mesh with Tackers . Group B 20 cases fixation a mesh with intracorporeal sutures. The study will be Conducted at Ain Shams University hospitals (El-Demerdash) and other authorized hospitals under supervision of thesis supervisors. Results smoking appears to be a risk factor for hernia development since almost 55% of the study group A and 65% of the study group B were smokers, obesity also appears to be a risk factor since BMI was about 30.20± 7.82 among group A and 32.05 ± 5.98 among group B. This is in contrast to age which seems not to be as strongly related. Conclusion we found the rate of postoperative early and late complications comparable in both groups. But in the LAP group we were able to discharge them from the hospital faster than the OPEN group, they also resumed full activity early.

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Background Single anastomosis sleeve ileal bypass (SASI) procedure appears as anew metabolic and bariatric surgery based on santoro's operation, in which sleeve gastrectomy is followed by side to side gastro-ileal loop anastomosis. Aim of the Work to compare between Single Anastomosis Sleeve Ileal Bypass (SASI) and Mini Gastric Bypass (OAGB) in treatment of morbid obesity. Patients and Methods Our study was a prospective randomized comparative study in Ain Shams University hospitals involving 50 patients suffering from morbid obesity and in whom surgical management was indicated. Our patients were randomly divided using closed envelopment method into two groups: Group (1): (25 patients) were treated by laparoscopic SASI. Group (2): (25 patients) were treated by laparoscopic MGB. Results One year after the surgery, there was significant diabetic remission rate and there was improvement of most of obesity-associated metabolic parameters Conclusion Our study suggests that both SASI and MGB are highly effective in controlling diabetes mellitus, hypertension and hyperlipidemia.