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Comparing outcomes of hand-assisted versus total laparoscopic gastric bypass.
Surg Obes Relat Dis. 2008 Mar-Apr; 4(2):91-5.SO

Abstract

BACKGROUND

Previous studies have compared open versus hand-assisted and open versus total laparoscopic Roux-en-Y gastric bypass. This study compared hand-assisted and total laparoscopic Roux-en-Y gastric bypass surgery performed at 2 institutions by 2 surgeons, each specializing in 1 of the techniques.

METHODS

Gastric bypass operations (n = 272) were evaluated from January 1, 2004 to December 31, 2004. The comparisons between the hand-assisted (n = 149) and laparoscopic (n = 123) approach were done using the median test, t test, chi-square analysis, and Fisher's exact test.

RESULTS

The average patient age was 43.9 years, and 84% (229 of 272) of the patients were women. The average body mass index was 48.8 kg/m2. No significant difference was found between the hand-assist and laparoscopic groups in age, gender, preoperative body mass index, diabetes, hypertension, or operative time. No significant difference was found in the mortality rate between the hand-assist (2 of 149, 1.3%) and laparoscopic (1 of 123, 0.8%) groups. Also, no significant difference was found in the incidence of leaks, pulmonary embolism, deep venous thrombosis, wound infection, bowel obstruction, incisional hernia, fistula, persistent vomiting, or reoperation between the 2 procedures. A significant difference was found in the length of stay, with a median of 3 days for the hand-assist group and 2 days for the laparoscopic group (P <.001), and hemorrhage requiring transfusion, which occurred in 1 (.7%) of 149 hand-assist patients and 7 (5.7%) of 123 laparoscopic patients (P = .025). The percentage of excess weight loss 6 months after surgery was also similar between the two groups, at 50.2% and 52.1% for the hand-assist and laparoscopic groups, respectively (P = .45).

CONCLUSIONS

The results of this study have found that both hand-assist and laparoscopic Roux-en-Y gastric bypass can be accomplished with similar perioperative risks and outcomes, including weight reduction. The choice between the 2 procedures depends on surgeon preference.

Authors+Show Affiliations

Department of Surgery, Good Samaritan Hospital, Cincinnati, Ohio, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17400031

Citation

Hassan, Mohammed, et al. "Comparing Outcomes of Hand-assisted Versus Total Laparoscopic Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 4, no. 2, 2008, pp. 91-5.
Hassan M, Kerlakian G, Curry T, et al. Comparing outcomes of hand-assisted versus total laparoscopic gastric bypass. Surg Obes Relat Dis. 2008;4(2):91-5.
Hassan, M., Kerlakian, G., Curry, T., Engel, A., & Bollmer, C. (2008). Comparing outcomes of hand-assisted versus total laparoscopic gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 4(2), 91-5.
Hassan M, et al. Comparing Outcomes of Hand-assisted Versus Total Laparoscopic Gastric Bypass. Surg Obes Relat Dis. 2008 Mar-Apr;4(2):91-5. PubMed PMID: 17400031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparing outcomes of hand-assisted versus total laparoscopic gastric bypass. AU - Hassan,Mohammed, AU - Kerlakian,George, AU - Curry,Trace, AU - Engel,Amy, AU - Bollmer,Cyndy, Y1 - 2007/04/02/ PY - 2006/07/26/received PY - 2006/09/21/revised PY - 2006/10/20/accepted PY - 2007/4/3/pubmed PY - 2008/6/27/medline PY - 2007/4/3/entrez SP - 91 EP - 5 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 4 IS - 2 N2 - BACKGROUND: Previous studies have compared open versus hand-assisted and open versus total laparoscopic Roux-en-Y gastric bypass. This study compared hand-assisted and total laparoscopic Roux-en-Y gastric bypass surgery performed at 2 institutions by 2 surgeons, each specializing in 1 of the techniques. METHODS: Gastric bypass operations (n = 272) were evaluated from January 1, 2004 to December 31, 2004. The comparisons between the hand-assisted (n = 149) and laparoscopic (n = 123) approach were done using the median test, t test, chi-square analysis, and Fisher's exact test. RESULTS: The average patient age was 43.9 years, and 84% (229 of 272) of the patients were women. The average body mass index was 48.8 kg/m2. No significant difference was found between the hand-assist and laparoscopic groups in age, gender, preoperative body mass index, diabetes, hypertension, or operative time. No significant difference was found in the mortality rate between the hand-assist (2 of 149, 1.3%) and laparoscopic (1 of 123, 0.8%) groups. Also, no significant difference was found in the incidence of leaks, pulmonary embolism, deep venous thrombosis, wound infection, bowel obstruction, incisional hernia, fistula, persistent vomiting, or reoperation between the 2 procedures. A significant difference was found in the length of stay, with a median of 3 days for the hand-assist group and 2 days for the laparoscopic group (P <.001), and hemorrhage requiring transfusion, which occurred in 1 (.7%) of 149 hand-assist patients and 7 (5.7%) of 123 laparoscopic patients (P = .025). The percentage of excess weight loss 6 months after surgery was also similar between the two groups, at 50.2% and 52.1% for the hand-assist and laparoscopic groups, respectively (P = .45). CONCLUSIONS: The results of this study have found that both hand-assist and laparoscopic Roux-en-Y gastric bypass can be accomplished with similar perioperative risks and outcomes, including weight reduction. The choice between the 2 procedures depends on surgeon preference. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/17400031/Comparing_outcomes_of_hand_assisted_versus_total_laparoscopic_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(06)00892-6 DB - PRIME DP - Unbound Medicine ER -