1 - YEAR RESULTS (12/2007 - 12/2008)
- Our Practice : We are a Bariatric Center of Excellence
- 120 primary laparoscopic gastric bypass surgeries
- 100% laparoscopic approach with no conversions to open surgery
- No deaths
- 1.6% complication rate
- Average hospital stay of only 1.7 days with a maximum of 4 days
- 30-day re-admission rate of only 3.3%
- 97.2% improvement or resolution of diabetes
- 100% improvement or resolution of hyperlipidemia
- 89.3% improvement or resolution of hypertension
- Average weight loss of 79 to 146 lbs (depending on preop BMI) at 9 months postoperatively with 0% failures
- Only program in the state which provides up-to-dated information to primary care physicians and patients about our own outcomes
- Only program with extensive experience with laparoscopic revisional bariatric surgery
- To improve the quality of life and health of our patients by adherence to long-term follow-up.
- To be available for follow-up of patients who had bariatric surgery elsewhere.
- To offer guaranteed and safe weight loss results.
DETAILED SUMMARY OF OUR RESULTS
Patient demographics
Age
|
41.3 (20.8-65.1)
|
Mean BMI (Kg/m 2)
|
47.1 (35-86.3)
|
Weight range (lbs)
|
283.7 (176-457.6)
|
Major complications after Laparoscopic Roux-en-Y Gastric Bypass
Complication
|
N (%)
|
Average length of stay
|
1.7 (1-4) days
|
Conversion to open surgery
|
0 (0%)
|
Early or late death
|
0 (0%)
|
Anastomotic leak
|
0 (0%)
|
Deep vein thrombosis / pulmonary embolism
|
0 (0%)
|
Hemorrhage
|
1/120 (0.8%)
|
30- day small bowel obstruction
|
1/120 (0.8%)
|
30-day re-explorations
|
3/120 (2.5%) (3 laparoscopies)
|
Early or late anastomotic ulcer
|
0 (0%)
|
Early or late anastomotic stricture
|
0 (0%)
|
Late small bowel obstruction
|
3/120 (2.5%)
|
Late re-explorations
|
3/120 (2.5%) (3 laparoscopies)
|
30-day re-admissions
|
4/120 (3.3%)
|
Weight Loss after Laparoscopic Roux-en-Y Gastric Bypass *
BMI
|
Preop weight (lbs)
|
3-month weight loss (lbs)
|
6-month weight loss (lbs)
|
9-month weight loss (lbs)
|
35-39.9
|
222.7
|
42.1
|
58.8
|
78.9
|
40-49.9
|
270.4
|
44.6
|
75.4
|
91.5
|
50-59.9
|
342.3
|
49
|
95
|
117.4
|
>60
|
393.1
|
62.9
|
125.2
|
146
|
* 1-year results are not shown since our first patient was operated on 12/3/2007 and only four of our patients have reached the 1-year follow-up. 1-year results will be shown in future updates.
Status of Major Co-morbid Conditions after Laparoscopic Roux-en-Y Gastric Bypass †
Co-morbid condition
|
Incidence
|
Resolution
|
Improvement
|
Unchanged or worsened
|
Diabetes
|
36/120 (30%)
|
17/36 (47.2%)
|
18/36 (50%)
|
1/36 (2.8%) *
|
Insulin-dependent DM
|
15/120 (12.5%)
|
5/15 (33.3%)
|
9/15 (60%)
|
1/15 (6.7%) *
|
Hypertension
|
65/120 (54.1%)
|
15/65 (23.1%)
|
43/65 (66.2%)
|
7/65 (10.7%)
|
Sleep apnea
|
69/120 (57.5%)
|
8/69 (11.6%)
|
47/69 (68.1%)
|
14/69 (20.3%)
|
Hyperlipidemia
|
74/120 (61.7%)
|
11/74 (14.9%)
|
63/74 (85.1%)
|
0
|
†Please note that this table shows the status of each co-morbid condition within 9 months from surgery. Since many of our patients have actually less than 9 month follow-up the resolution or improvement of each co-morbidity reflects early results. Longer-term results may actually be better.
* This patient is only 6 weeks from surgery
Laparoscopic revisions of other bariatric procedures to gastric bypass
30 - day outcomes
No bariatric surgery revisions
|
9
|
% completed laparoscopically
|
87.5%
|
Mean length of stay (days)
|
2.1 (2-3)
|
Deaths
|
0
|
Anastomotic leaks
|
0
|
DVT/PE
|
0
|
Bleeding
|
0
|
Obstruction
|
0
|
Other complications
|
1- cryptogenic stroke of unclear etiology without residual deficit
|
Re-operations
|
0
|
Re-admissions
|
1/9, (11.1%)
|
All Bariatric surgeries
>30 - day outcomes
No bariatric surgeries
|
129
|
No primary bariatric surgeries
|
120
|
Deaths
|
0
|
Anastomotic leaks
|
0
|
DVT/PE
|
0
|
Bleeding
|
0
|
Anastomotic stricture
|
0
|
Anastomotic ulcer
|
0
|
Obstruction
|
3/120 (2.5%)- all repaired laparoscopically
|
Re-operations
|
3/120 (2.5%)
|
No bariatric surgery revisions
|
9
|
Deaths
|
0
|
Anastomotic leaks
|
0
|
DVT/PE
|
0
|
Bleeding
|
0
|
Anastomotic stricture
|
0
|
Anastomotic ulcer
|
0
|
Obstruction
|
0
|
Re-operations
|
0
|
Other procedures performed at Bariatric Center
Procedure
|
No
|
Complications
|
Laparoscopic right colon resection with intra-corporeal anastomosis
|
1
|
none
|
Laparoscopic right colon resection with extra-corporeal anastomosis
|
1
|
none
|
Laparoscopic abdominoperineal resection
|
1
|
Wound infection
|
Laparoscopic ventral hernia repair with mesh
|
16
|
none
|
Laparoscopic repair of diaphragmatic hernia
|
7
|
None
|
Laparoscopic Heller esophago-myotomy
|
1
|
None
|
Laparoscopic total gastrectomy
|
1
|
None
|
Laparoscopic cholecystectomy
|
15
|
1 bile leak
|
Laparoscopic liver biopsy
|
3
|
none
|