Publication:
Surgical Technology International XX - Bariatric Surgery
Article title:
Laparoscopic Jejunal Sleeve: A Simple and Ideal New Technique for Revision of Roux-en-Y Gastric Bypass After Weight Regains Technical Aspects
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Author(s)
Michel Gagner, MD, FRCSC, FACS, FICS, FASMBS
Clinical Professor of Surgery, Department of Surgery
Herbert Wertheim College of Medicine, Florida International University
Miami, FL
Abstract
Revision of gastric bypasses that fail is one of the most difficult challenges that face bariatric surgeons these days. Adding a foreign body like a band or a silastic may give unsatisfactory results, while increasing malabsorption may result in severe malnutrition and hypoproteinemia. Laparoscopic jejunal sleeve is based on the principles of laparoscopic sleeve gastrectomy applied to a failed Roux-en-Y gastric bypass. The procedure is simple and involves only stapling, is reproducible, accessible, effective, and safe, without foreign bodies. Weight loss may be achieved to give an extra 5 to 10 points of BMI reduction. Early complications are similar to laparoscopic sleeve gastrectomy and may involve leaks and strictures. Mid- and long-term weight loss data are lacking at the present time, and patients should be selected based on an initial response to their gastric bypass.
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