Study Confirms Value of Laparoscopy for Obesity

The study was published in the October issue of the Annals of Surgery.

The surgery, called laparoscopic Roux-en-Y gastric bypass, is a minimally invasive procedure, with surgeons making four or five small incisions rather than one large one to access the abdominal cavity. They then construct a small stomach pouch and bypass a small segment of intestines by constructing a Y-shaped limb of small bowel.

The study involved 275 patients, aged 17-68, who averaged over 300 pounds prior to surgery. Many had other medical problems such as diabetes, sleep apnea, and cardiopulmonary disease, and 63% had undergone prior abdominal surgery. Only 3.3% has major complications. Following surgery, excess weight loss at 24 and 30 months was 83% and 77%.

At one year follow-up, 95% of the patients reported significant improvement in their quality of life. Among patients with osteoarthritis, 47% said their condition was improved, and 41% said it was resolved. Among patients with hypertension, 70% said the condition was resolved following surgery. Diabetics has the most profound improvement, claiming an 83% cure rate.

The important outcomes relating to the goal of open bariatric surgery such as weight loss and improvement of comorbidities and quality of life appear to be equally favorable for minimally invasive gastric bypass, noted Philip Schauer, M.D., assistant professor of surgery and director of bariatric surgery at the University of Pittsburgh School of
Medicine (PA, USA). Long-term follow-up, however, will be necessary to confirm that the laparoscopic approach is equally enduring.