Indikation, Technik und Ergebnisse nach laparoskopischer Magen-Bypass-Operation

Weiner, Rudolf A.; Engert, R. Blanco; Weiner, Sylvia

doi:10.1007/978-3-642-55715-6_118

Cited by 1 publication

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“…From empirical bariatric surgery, we know that the measurement is performed starting at the ligament of Treitz and a lot of surgeons use different lengths of alimentary (AL) and biliopancreatic (BPL) limbs. But again, the length of 2 m (this time in the proximal small intestine) is used by many surgeons in different combinations: 150 cm of AL with 50 cm BPL [ 31 – 33 ], 120 cm AL and 80 cm BPL [ 34 ], and 200 cm of jejunal bypass when performing an MGB [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Duodeno-enteral omega switches - more physiological techniques in metabolic surgery.

Karcz¹,

Kuesters²,

Marjanović³

et al. 2013

Videosurgery and Other Miniinvasive Techniques

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IntroductionIn bariatric surgery, still new surgical techniques are developed. On the one hand, the Roux-en-Y gastric bypass (RYGB) is one of the most common procedures used. However, many patients experience dumping syndrome or pain due to bile reflux. On the other hand, revisions after gastric banding are frequent and may be technically challenging.AimTo create a new bariatric procedure counterbalancing the drawbacks of conventional RYGB, also suitable as a redo option after gastric banding.Material and methodsTo diminish the complication rate and pathophysiological disadvantages in reoperations after gastric banding, we primarily combined a gastric plication (GP) with a single anastomosis duodeno-ileal omega switch (DIOS), bypassing 2/3 of the total bowel length. Further on, in patients with lower body mass index we combined a GP or LSG and laparoscopic sleeve gastrectomy with a duodeno-jejunal omega switch (DJOS), performing an end-to side anastomosis after 1/3 of the total bowel length.ResultsThe DIOS and DJOS techniques restrict food intake and bypass the duodenum and part (DJOS) or the whole (DIOS) jejunum. Restriction is achieved either through gastric plicature or conventional sleeve gastrectomy.ConclusionsSimilar bariatric and metabolic effects to proximal RYGB are expected in the case of DJOS, or to a conventional duodenal switch when performing a DIOS procedure. Performing a gastric plicature will reduce the risk of gastric leak when revising patients after failed gastric banding.

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