Gastric Bypass

Collins, Brendan; Miyashita, Tomoharu; Schweitzer, Michael; Magnuson, Thomas; Harmon, John W.

doi:10.1001/archsurg.142.10.1000

Cited by 37 publications

(10 citation statements)

References 20 publications

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“…We show here that the model replicates some, but not all, physiological changes reported after RYGB in humans [16], [17], [18] and rodents [8], [12], [19], [20]. The 30% sustained weight loss, almost complete loss of excess fat mass, increased energy expenditure, and improved glucose homeostasis are similar to reports in other preclinical and clinical studies, but the quite significantly increased food intake and the complete sparing of lean mass have not been reported in human studies or in most rodent studies.…”

Section: Discussionsupporting

confidence: 73%

Development and Verification of a Mouse Model for Roux-en-Y Gastric Bypass Surgery with a Small Gastric Pouch

et al. 2013

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Existing mouse models of Roux-en-Y gastric bypass (RYGB) surgery are not comparable to human RYGB in gastric pouch volume for a large or absent gastric volume. The aim of this study was to develop and characterize a mouse RYGB model that closely replicates gastric pouch size of human RYGB surgery of about 5% of total gastric volume. We established this model in diet-induced obese (DIO) mice of C57BL/6J. This surgery resulted in a sustained 30% weight loss, entirely accounted for by decreased fat mass but not lean mass, compared to sham-operated mice on the high fat diet. Compared to sham-operated mice, energy expenditure corrected for total body weight was significantly increased by about 25%, and substrate utilization was shifted toward higher carbohydrate utilization at 8 weeks after RYGB when body weight had stabilized at the lower level. The energy expenditure persisted and carbohydrate utilization was even more pronounced when the mice were fed chow diet. Although significantly increased during daytime, overall locomotor activity was not significantly different. In response to cold exposure, RYGB mice exhibited an improved capacity to maintain the body temperature. In insulin tolerance test, exogenous insulin-induced suppression of plasma glucose levels was significantly greater in RYGB mice at 4 weeks after surgery. Paradoxically, food intake measured at 5 weeks after surgery was significantly increased, possibly in compensation for increased fecal energy loss and energy expenditure. In conclusion, this new model is a viable alternative to existing murine RYGB models and the model matches human RYGB surgery in anatomy. This model will be useful for studying molecular mechanisms involved in the beneficial effects of RYGB on body weight and glucose homeostasis.

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Section: Discussionsupporting

confidence: 73%

Development and Verification of a Mouse Model for Roux-en-Y Gastric Bypass Surgery with a Small Gastric Pouch

et al. 2013

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“…Under the scheme, operation time and postoperative hospital stay and the rate of post-operative complications in patients with Roux-En-Y Gastric Bypass was more and weight loss in this group was less through a 5-year follow-up [12]. Excessive weight loss in mini gastric bypass after one year in our study was similar to other published studies [4]. In another study in 2008 on 16 patients under mini gastric bypass surgery results showed that patients had 78-minute surgery and postoperative hospital stay 1.2 days.…”

Section: Discussionsupporting

confidence: 86%

“…In mini gastric bypass surgery, duration of surgery is about 30 minutes and hospital stay between 1 to 3 days while in the method of Roux-En-Y Gastric Bypass, duration of surgery was more than an hour and length of stay in hospital is between 4 and 8 days [3] [4]. In this study, candidate for bypass surgery referred to obesity clinic of Rasoul Akram Hospital during year 2013-2014, were randomly divided into two groups and one group underwent Roux-En-Y Gastric Bypass and the second group Mini Gastric Bypass and the difference between the two groups were studied.…”

Section: Introductionmentioning

confidence: 99%

Excessive Weight Loss Following Laparoscopic Gastric Mini Bypass or Roux-En-Y Gastric Bypass Surgery

Pazouki¹,

Esmaeili²

2016

IJCM

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Background: More than 90 percent of obesity surgery is done using a laparoscope. This method is superior to open surgery and lead to fewer complications, shorter hospital stay and faster recovery. This study compared course of weight loss following laparoscopic Gastric Mini Bypass or Roux-En-Y Gastric Bypass surgery, after one year of follow up. Materials and Methods: This randomized clinical trial was conducted among obese patients admitted to Rasoul Akram Hospital Obesity Clinic, Half underwent laparoscopic Roux-En-Y Gastric Bypass and the rest were undergoing laparoscopic Mini Gastric Bypass. The amount of weight loss during the first year after surgery will be discussed. Results: In this study, 75 obese patients were studied. Most of the participants were female (82.7%). Participants aged between 18 and 59 years old (average = 36.8 ± 9.8 y/o). Before the surgery, there was no significant difference in weight between the two groups. Excessive weight loss after one month, six months nine months and one year between the two groups was significant and was more in Mini Gastric Bypass (p < 0.05). Conclusion: Respecting the benefits of Mini Gastric Bypass compared to the Roux-En-Y Gastric Bypass technique, it is suggested for patients with morbid obesity.

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“…The laparoscopy tower is placed on the right of the patient's head 7 , 12 , 13 , 14 . The surgery is performed under general anesthesia with endotracheal intubation.…”

Section: Methodsmentioning

confidence: 99%

Simplified Laparoscopic Gastric Bypass With Gastrojejunal Linear Mechanical Anastomosis: Technical Aspects

Palermo

Serra

2016

ABCD, arq. bras. cir. dig.

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Background:Gastric bypass is a restrictive and malabsorptive surgery. The restrictive part consists in the creation of a small gastric pouch. The gastrointestinal bypass serves as the malabsorptive element.Aim: To describe a simplified gastric bypass approach for morbid obese patients, showing our results, and also remarking the importance of this technique for reducing the learning curve.Method:The patient is positioned in a split legs position and carefully strapped to the operating room table, with the surgeon between the patient's legs. Five trocars are inserted after pneumoperitoneum at the umbilicus. Dissection of the esophagogastric angle and lesser curvature is mandatory before the gastric pouch manufacturing. This pouch is done with two blue load staplers. Using a blue load linear stapler inserted only half way into the hole in the pouch is used to perform the gastrojejunal anastomosis and in order to create an anastomosis that is about 2 cm in length. A side-to-side jejunojejunostomy is done with a white load linear stapler. The last step of the gastric bypass consists in the cut of the jejunum between the two anastomosis with a white load linear stapler. Blue test is performed in order to detect leaks.Results: From January 2012 to December 2015, 415 simplified RYGB were performed. Gender: 67% female and 33 % males. Average of BMI 44.7. Mean age was 42 years old. Mean operative time 79 min. 39 % of this sample had T2 diabetes. Regarding complications were observed, one fistula, one gastrojejunal stenosis and one obstruction due to a bezoar.Conclusion: The described technique is a simplified approach in which all the anastomosis are performed in the upper part of the abdomen, allowing the surgeons to be more systematized and avoiding them to make mistakes in the confection of the Roux-en-Y anastomosis. This simplified gastric bypass is a safe and reproducible technique.

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Gastric Bypass

Cited by 37 publications

References 20 publications

Development and Verification of a Mouse Model for Roux-en-Y Gastric Bypass Surgery with a Small Gastric Pouch

Development and Verification of a Mouse Model for Roux-en-Y Gastric Bypass Surgery with a Small Gastric Pouch

Excessive Weight Loss Following Laparoscopic Gastric Mini Bypass or Roux-En-Y Gastric Bypass Surgery

Simplified Laparoscopic Gastric Bypass With Gastrojejunal Linear Mechanical Anastomosis: Technical Aspects

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