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. 2022 Nov 18:84:104914.
doi: 10.1016/j.amsu.2022.104914. eCollection 2022 Dec.

The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass

Neda Haghighat  1 , Hooman Kamran  1 , Mohammad Naser Moaddeli  1 , Babak Hosseini  1 , Ali Karimi  1 , Iman Hesameddini  1 , Masoud Amini  1 , Seyed Vahid Hosseini  1   2 , Abtin Vahidi  1 , Nader Moeinvaziri  1
Affiliations

The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass

Neda Haghighat et al. Ann Med Surg (Lond). .

Abstract

Introduction: No standard of anatomical variables, including stoma size, limb length, pouch size, and volume, has been determined for laparoscopic Roux-en-Y gastric bypass yet. Herein, we evaluated the effect of two different techniques for creating the gastric pouch on short-term postoperative weight loss.

Methods: This retrospective cohort was conducted on patients with a laparoscopic Roux-en-Y gastric bypass history from January 2019 to September 2020. Patients were divided into two groups: in one group, patients' gastric pouch was made using two 60 mm linear staplers, while in the other group, the gastric pouch was made using three 60 mm linear staplers. Anthropometric data, including weight, height, and body mass index (BMI), were measured preoperatively and six months following surgery. Weight outcomes, such as weight loss, a decrease in BMI, excess weight loss (%EWL), and total weight loss (%TWL), were calculated as short-term weight outcomes.

Results: Two groups, each containing 50 patients, were included. Patients with smaller pouches (two staplers) had 32.4 ± 9.2 kg weight loss, and those with larger pouches (three staplers) had a 31.42 ± 10.3 kg weight loss. Also, %EWL was 69.7 ± 14.9 and 63.0 ± 20.9, and %TWL was 28.2 ± 6.0 and 26.14 ± 7.5 in patients with two stapler pouches and three stapler pouches, respectively. None of the weight outcome parameters were significantly different between the groups (p-value>0.05).

Conclusion: Various studies have been conducted, resulting in different conclusions regarding the effect of the size of the gastric pouch on weight loss. One of the major differences contributing to varying literature studies results is the measurement method used for gastric pouch size. We conclude that using two staplers is not a way to achieve a better result. As the best measurement method has not been defined, studies comparing different methods are suggested; here, the aim was to use a more simple and clinical method regarding this issue.

Keywords: Bariatric surgery; Gastric bypass; Pouch; Surgical staplers; Weight loss.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Scheme for both techniques of Roux-en-Y gastric bypass; A) two-stapler and B) three-stapler.
Fig. 2
Fig. 2
The comparison of weight loss, BMI reduction, %EWL, and %TWL between the two-stapler and three-stapler groups; none of the differences were statistically significant (p-value>0.05). BMI; body mass index, %EWL: excess weight loss, %TWL: total weight loss.
See this image and copyright information in PMC

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