Laparoscopic vs open gastric bypass in the management of morbid obesity: A 7-year retrospective study of 1,364 patients from a single center

Methods: We performed a retrospective analysis of 1,364 consecutive morbidly obese patients who underwent restrictive-malabsorptive Roux-en-Y gastric bypass (RYGBP) between January 1998 and December 2004. A selective use of open and laparoscopic approaches was employed since 2001. Patients were seen in the office at 1 week; 2, 3, 6, 9, 12, and 24 months; and yearly thereafter. During visits, each patient was weighed and dietary intake and exercise regimen were recorded. Results: We report a sustained weight reduction in over 90% of patients. The anastomotic leak rate was 0.15%, the 30-day readmission rate was 1.17%, and the overall mortality rate was 0.15%. Minor surgical site infection rate was 0.5%, and revision to long limb RYGBP rate was 0.07%. Conclusions: Morbid obesity represents a significant health issue. None of the medical methods of weight reduction provide a lasting weight reduction. Surgery offers the only achievable long-term solution. Although not yet universally employed, laparoscopic RYGBP is rapidly becoming the standard operation for the surgical treatment of clinically severe obesity.