Laparoscopic roux-en-y gastric bypass: Single centre experience of 420 cases Wilson MSJ, Alhamdani A, Mahawar K, Boyle M*, Schroeder N, Balupuri S, Small PK Departments of General Surgery and Dietetics*, Sunderland Royal Hospital, Kayll Road, Sunderland, SR4 7TP, UK. Aims We have performed 420 Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) between January 2005 and February 2011. This study aims to evaluate our experience to date with this procedure. Methods Data was analysed from a prospectively maintained database. Study end points included; operating time, postoperative hospital stay, early (<30 days) and late (>30 days) readmissions and complications and mean percentage excess weight loss. Results 420 patients were scheduled for LRYGB. Another 6 underwent open surgery electively and were excluded from the data analysis. Patient demographics and previous bariatric surgery is displayed in Table 1. Perioperative (<30 days) and follow up (>30 days) data are shown in Tables 2 & 3. Early and late complications are shown in Figures 1 & 2 respectively. Weight loss post LRYGB is displayed in Table 4. 1 patient died 10 months post LRYGB. Figure 2 – Late (>30d) complications post LRYGB Time since LRYGB Mean % excess weight loss (range) 6 months 54.2 (22.2 to 99.8) 1 year 64.2 (11.0 to 113.3) 2 years 67.3 (6.2 to 105.8) 3 years 65.2 (28.6 to 101.6) 4 years 64.3 (30.2 to 90.8) Mean age 43.6 years Females (%) 346 (82.4%) Mean preoperative BMI 51.1 kg/m2 Patients with BMI ≥60 49 (11.7%) Patients age ≥60 years 21 (5.0%) Intragastric balloon 48 (11.4%) Gastric band 41 (9.8%) Table 1 – Patient demographics & bariatric history Table 4 – Mean % excess weight loss post LRYGB Discussion Mean operating time 2h 53m Mean post op hospital stay 3.3 days Early (<30d) readmission rate 5.9% Conversion to open (%) 3 (0.7%) Table 2 – Perioperative outcomes (<30 days) We report safe and effective performance of LRYGB in our unit, with acceptable morbidity, mortality and weight loss that is comparable with other published studies1-3. Our results include the learning curve of all three consultant surgeons. Anastamotic strictures occurred at the gastro-jejunostomy in the first 100 patients where circular stapler was used. That was changed subsequently to linear gastro-jejunostomy with resolution of this complication. References Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004 Oct 13;292(14):1724-37. Wittgrove AC, Clark GW. Laparoscopic Roux-en-Y gastric bypass in 500 patients: technique and results, with 3-60 month follow-up. Obes Surg 2000;10:233-9. Higa KD, Boone KB, Ho T et al. Complications of the laparoscopic Roux-en-Y gastric bypass: 1040 patients – what have we learned? Obes Surg 2000;10:509-13. Figure 1 – Early (<30 days) complications post LRYGB Late (>30d readmission rate) 11.5% Mean follow-up 17.4 months Post op cholecystectomy 10 (2.4%) Mortality 0.2% Table 3 – Follow up data (>30 days)