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Precise Laparoscopic Roux-en-Y Gastric Bypass: A New Concept in Bariatric and Metabolic Surgery

Yang, Wah MD; Wang, Cunchuan MD, PhD; Yang, Jingge MD

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: June 2015 - Volume 25 - Issue 3 - p e98–e100
doi: 10.1097/SLE.0000000000000132
Online Articles: Original Articles

Purpose: Bariatric surgery is technically complex. It is important to refine existing methods and explore new techniques to improve the outcomes of patients. We discuss the characteristics and applications of the precise laparoscopic Roux-en-Y gastric bypass (PLRYGB) in clinical practice.

Materials and Methods: We retrospectively analyzed the clinical records of obese patients who underwent laparoscopic Roux-en-Y gastric bypass between 2009 and 2012, and compared surgical data, postoperative recovery, weight loss, and complications of patients who underwent PLRYGB with those who underwent conventional laparoscopic Roux-en-Y gastric bypass (CLRYGB) surgery.

Results: Of 211 patients, 89 underwent CLRYGB and 122 PLRYGB. Although the operating time for PLRYGB was significantly longer than CLRYGB (149±23 min vs. 138±23 min, P<0.05), length of hospital stay was shorter in those undergoing the precise technique (4.2±1.1 d for PLRYGB and 7.7±1.5 d for CLRYGB, P<0.05), and the percentage of excess weight lost 18 months after surgery was greater (78.4±8.2% for PLRYGB and 64.5±8.4% for CLRYGB, P=0.000). Five patients (5.6%) who underwent conventional surgery experienced postoperative complications, including 1 anastomotic leak and 1 internal hernia; 1 patient required redo surgery, and 2 corrective surgery. There were no postoperative complications in the PLRYGB group.

Conclusions: PLRYGB is safe and feasible. The precise approach did not substantially increase operating time but decreased duration of hospital stay and the incidence of postoperative complications, whereas weight loss outcomes were significantly better.

Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, Guangdong Province, China

The author declares no conflicts of interest.

Reprints: Cunchuan Wang, MD, PhD, Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, 613 Huangpu Avenue West, Guangzhou 510630, Guangdong Province, China (e-mail:

Received February 17, 2014

Accepted January 22, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.