Skip to main content

Advertisement

Log in

Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study of 117 Patients

  • Clinical Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most widely used bariatric procedures today, and laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In this study, we prospectively compared both techniques in order to establish whether there is any superiority of one over the other based on morbidity and effectiveness. From January 2008 to December 2008, 117 obese patients with indication for bariatric surgery were assigned by patient choice after informed consent to either a LRYGB procedure (n = 75) or a LSG procedure (n = 42). We determined operative time, length of stay, morbidity, co-morbidity outcomes, and excess weight loss at 1 year postoperative. Both groups were comparable in age, sex, body mass index, and co-morbidities. Mean operative time of LSG was 82 min while LRYGB was 98 min (p < 0.05). Differences in length of stay, major complications, improvement in co-morbidities, and excess weight loss were not significant (p > 0.05). One year after surgery, average excess weight loss was 86% in LRYGB and 78.8% in LSG (p > 0.05). In the short term, both techniques are comparable regarding safety and effectiveness, so not one procedure is clearly superior to the other.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Satia-Abouta J. Dietary acculturation: definition, process, assessment, and implications. IJHE. 2003;4:71–86.

    Google Scholar 

  2. Lacy A, Delgado S. Controversias en Cirugía Laparoscópica de la obesidad. Contraindicaciones y límites de la cirugía laparoscópica. Cir Esp. 2004;75:287–9.

    Google Scholar 

  3. Samuel I, Mason E, Renquist K, et al. Bariatric surgery trends: an 18-year report from the International Bariatric Surgery Registry. Am J Surg. 2006;192:657–62.

    Article  PubMed  Google Scholar 

  4. Nguyen NT, Goldman C, Rosenquist J, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and cost. Ann Surg. 2001;234:279–91.

    Article  CAS  PubMed  Google Scholar 

  5. Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.

    Article  PubMed  Google Scholar 

  6. Picot J, Jones J, Colquitt JL, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for morbid obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13:41.

    Google Scholar 

  7. Søvik TT, Aasheim ET, Kristinsson J, et al. Establishing laparoscopic Roux-en-Y gastric bypass: perioperative outcome and characteristics of the learning curve. Obes Surg. 2009;19:158–65.

    Article  PubMed  Google Scholar 

  8. Stephens DJ, Saunders JK, Belsley S, et al. Short-term outcomes for super-super obese (BMI > or =60 kg/m2) patients undergoing weight loss surgery at a high-volume bariatric surgery center: laparoscopic adjustable gastric banding, laparoscopic gastric bypass, and open tubular gastric bypass. Surg Obes Relat Dis. 2008;4:408–15.

    Article  PubMed  Google Scholar 

  9. Aggarwal S, Kini SU, Herron D. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007;3:189–94.

    Article  PubMed  Google Scholar 

  10. Baltazar A, Serra C, Perez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15:1124–8.

    Article  Google Scholar 

  11. Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.

    Article  PubMed  Google Scholar 

  12. Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.

    Article  PubMed  Google Scholar 

  13. Weiner RA, Weiner S, Pomhoff I, et al. Laparoscopic sleeve gastrectomy—influence of sleeve size and resected gastric volume. Obes Surg. 2007;17:1297–305.

    Article  PubMed  Google Scholar 

  14. Braghetto I, Korn O, Valladares H, et al. Laparoscopic sleeve gastrectomy: surgical technique, indications and clinical results. Obes Surg. 2007;17:1442–50.

    Article  PubMed  Google Scholar 

  15. Iannelli A, Dainese R, Piche T, et al. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol. 2008;14:821–7.

    Article  PubMed  Google Scholar 

  16. Nocca D, Krawczykowsky D, Bomans B, et al. A prospective multicenter study of 163 sleeve gastrectomies: results at 1 and 2 years. Obes Surg. 2008;18:560–5.

    Article  CAS  PubMed  Google Scholar 

  17. Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic sleeve gastrectomy without an over-sewing of the staple line. Obes Surg. 2008;18:1257–62.

    Article  PubMed  Google Scholar 

  18. Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.

    Article  PubMed  Google Scholar 

  19. Fuks D, Verhaeghe P, Brehant O, et al. Results of laparoscopic sleeve gastrectomy: a prospective study in 135 patients with morbid obesity. Surgery. 2009;145:106–13.

    Article  PubMed  Google Scholar 

  20. Brethauer SA, Hammel JP, Schauer PR. Systematic review of sleeve gastrectomy as staging and primary bariatric procedure. Surg Obes Relat Dis. 2009;5:469–75.

    Article  PubMed  Google Scholar 

  21. Rubin M, Yehoshua RT, Stein M, et al. Laparoscopic sleeve gastrectomy with minimal morbidity. Early results in 120 morbidly obese patients. Obes Surg. 2008;18:1567–70.

    Article  PubMed  Google Scholar 

  22. Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.

    Article  CAS  PubMed  Google Scholar 

  23. Ross MD, Gagner M. The first International Consensus Summit for sleeve gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.

    Article  Google Scholar 

  24. Felberbauer FX, Langer F, Shakeri-Manesch S, et al. Laparoscopic sleeve gastrectomy as an isolated bariatric procedure: intermediate-term results from a large series in three Austrian centers. Obes Surg. 2008;18:814–8.

    Article  PubMed  Google Scholar 

  25. Karamanakos SN, Vagenas K, Kalfarentzos F, et al. Weight loss, appetite suppression, and changes in fasting and postprandial ghrelin and paptide-YY levels after Roux-en-Y gastric bypass and sleeve gastrectomy. A prospective, double blind study. Ann Surg. 2008;247:401–7.

    Article  PubMed  Google Scholar 

  26. Lakdawala MA, Bhasker A, Mulchandani D, et al. Comparison between the results of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass in the indian population: a retrospective 1 year study. Obes Surg. 2010;20:1–6.

    Article  PubMed  Google Scholar 

  27. Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery: comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy: a prospective randomized trial. Ann Surg. 2009;250:234–41.

    Article  PubMed  Google Scholar 

  28. Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)-a prospective study. Obes Surg. 2010;20:447–53.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest Disclosure

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jose Luis Leyba.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Leyba, J.L., Aulestia, S.N. & Llopis, S.N. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy for the Treatment of Morbid Obesity. A Prospective Study of 117 Patients. OBES SURG 21, 212–216 (2011). https://doi.org/10.1007/s11695-010-0279-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-010-0279-8

Keywords

Navigation