Background: During November 98 to April 2007 we performed 3000 bariatric procedures that including: 29% Lap-Band, 41% Gastric By Pass, 26% BIB and 4% BPD. The choice of the method was defined by protocols developed into a multidisciplinary team, considering BMI, social and eating profile, surgery risk, agreement to physical activity and patient’s expectation.
Methods: In the first two years, we performed Gastric By Pass with Ring in 180 cases with 85% of excess weight loss after two years. We perceived with this kind of surgery the patients had too much difficult with solid foods. Therefore we decided to perform the surgery without ring. There were 274 cases with 69% of excess weight loss in two years and better eating quality. In the last four years we began to perform Laparoscopic Roux-en-Y Gastric By Pass with a Distal Jejunum-Ileal Diversion distant about 1,5 to 2,0m from ileo-cecal valve(n=776). The surgery is all performed in a supra-mesocolic abdominal area. The gastroenteoanastomosis is always pre- gastric and precolic performed with linear stapler and we first make the enteroenteroanastomosis an than staples the intestine. So that, we cant test the both anastomosis with blue of methylene.
Results and Conclusion: We had done 776 cases using this method, with 86% of excess weight loss two years after the surgery. With this technique we are able to reduce surgery time, avoid ring complications ( erosion, slippage), getting the same perceptual of excess weight loss not using ring, no nutritional effects in long term, and much better eating quality for the patients.
Program Number: P049