%0 Journal Article
%T Laparoscopic adjustable banded roux-en-y gastric bypass as a primary procedure for the super-super-obese (body mass index > 60 kg/m2)
%A Bruno Dillemans
%A Sebastiaan Van Cauwenberge
%A Sanjay Agrawal
%A Els Van Dessel
%A Jan-Paul Mulier
%J BMC Surgery
%D 2010
%I BioMed Central
%R 10.1186/1471-2482-10-33
%X In a primary laparoscopic RYGB, an AGB is drawn around the gastric pouch through a small opening between the blood vessels on the lesser curve and the gastric pouch. The band is then fixed by suturing the gastric remnant to the gastric pouch both above and below the band to prevent slippage.Between November 2009 and March 2010, 6 consecutive super-super-obese patients underwent a primary laparoscopic adjustable banded Roux-en-Y gastric bypass procedure at our institution. One male patient (21 years, BMI 70 kg/m2) developed a pneumonia postoperatively. No other postoperative complications were observed.To the best of our knowledge, this is the first series of patients that underwent a laparoscopic adjustable banded RYGB as a primary operation for the super-super obese in the indexed literature. With the combined procedure, a sequential action mechanism for weight loss is to be expected. The restrictive, malabsorptive and hormonal working mechanism of the RYGB will induce weight loss from the start reaching a stabilised plateau of weight after 12 - 18 months. At that time, filling of the band can be started resulting in further gastric pouch restriction and increased weight loss. Moreover, besides improving the results of total weight loss, a gradual filling of the band can as well prevent the RYGB patient from weight regain if restriction would fade away with time.Currently, there is no consensus opinion regarding the surgical procedure of choice in super-super morbid obesity (Body mass index, BMI > 60 kg/m2). Following a debate during the 2005 annual meeting of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), surgeons choose laparoscopic gastric bypass as the procedure of choice in a hypothetical super-super obese patient case scenario [1]. Unfortunately, there is very little published data examining and comparing the outcomes in super-super obese patients with any of the well known bariatric procedures.Since its first description in open su
%U http://www.biomedcentral.com/1471-2482/10/33