Laparoscopic Roux-en-Y gastric bypass：from history to precise and specification_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Chengcan , WANG Wenyue , MA Shuai , ZHU Dongzi , DAI Qiancheng ,  WANG Bing

Department of Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P. R. China;

Corresponding author：

WANG Bing, Email: wingping01@126.com

Keywords：

Roux-en-Y gastric bypass; obesity; metabolic diseases; history; precision; specification; metabolic and bariatric surgery

DOI：

10.7507/1007-9424.202310018

Video：

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Laparoscopic Roux-en-Y gastric bypass (LRYGB) was recommended as the gold standard procedure for metabolic and bariatric surgery by the National Institutes of Health in the 1990s and then had been adopted till now, which could effectively control excess weight and treat metabolic diseases relevant to obesity in a long term. The current LRYGB procedure had been performed more than half a century of development and update, and is still constantly evolving. Standardized and precise surgical procedures are of great significance in ensuring treatment effect and reducing the incidence of complications. Thus, the author reviewed the development process of LRYGB, further understanding and emphasizing the importance of standardized and precise surgical procedures.

Citation： YANG Chengcan, WANG Wenyue, MA Shuai, ZHU Dongzi, DAI Qiancheng, WANG Bing. Laparoscopic Roux-en-Y gastric bypass：from history to precise and specification. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(4): 394-397. doi: 10.7507/1007-9424.202310018 Copy

1.	Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am, 1967, 47(6): 1345-1351.
2.	Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg, 1994, 4(4): 353-357.
3.	Varela JE, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U. S. utilization of bariatric surgery at Academic Medical Centers. Surg Obes Relat Dis, 2015, 11(5): 987-990.
4.	大中华减重与代谢手术数据库研究者团队. 大中华减重与代谢手术数据库2022年度报告. 中国实用外科杂志, 2023, 43(5): 540-551.
5.	Salminen P, Grönroos S, Helmiö M, et al. Effect of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass on weight loss, comorbidities, and reflux at 10 years in adult patients with obesity: the SLEEVEPASS randomized clinical trial. JAMA Surg, 2022, 157(8): 656-666.
6.	中华医学会外科学分会甲状腺及代谢外科学组, 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国肥胖及2型糖尿病外科治疗指南(2019版). 中国实用外科杂志, 2019, 39(4): 301-306.
7.	Henrikson V. Can small bowel resection be defended as therapy for obesity?. Obes Surg, 1994, 4(1): 54. doi: 10.1381/096089294765558926.
8.	Kremen AJ, Linner JH, Nelson CH. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg, 1954, 140(3): 439-448.
9.	Payne JH, Dewind LT, Commons RR. Metabolic observations in patients with jejunocolic shunts. Am J Surg, 1963, 106: 273-89.
10.	Bray GA. Current status of intestinal bypass surgery in the treatment of obesity. Diabetes, 1977, 26(11): 1072-1079.
11.	Hocking MP, Duerson MC, O’Leary JP, et al. Jejunoileal bypass for morbid obesity. Late follow-up in 100 cases. N Engl J Med, 1983, 308(17): 995-999.
12.	Griffen WO Jr, Bivins BA, Bell RM. The decline and fall of the jejunoileal bypass. Surg Gynecol Obstet, 1983, 157(4): 301-308.
13.	Singh D, Laya AS, Clarkston WK, et al. Jejunoileal bypass: a surgery of the past and a review of its complications. World J Gastroenterol, 2009, 15(18): 2277-2279.
14.	DeWind LT, Payne JH. Intestinal bypass surgery for morbid obesity: long-term results. JAMA, 2014, 312(9): 966. doi: 10.1001/jama.2014.10853.
15.	Bray GA, Barry RE, Benfield JR, et al. Intestinal bypass surgery for obesity decreases food intake and taste preferences. Am J Clin Nutr, 1976, 29(7): 779-783.
16.	Mason EE, Ito C. Gastric bypass. Ann Surg, 1969, 170(3): 329-339.
17.	Griffen WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg, 1977, 186(4): 500-509.
18.	Buckwalter JA. A prospective comparison of the jejunoileal and gastric bypass operations for morbid obesity. World J Surg, 1977, 1(6): 757-768.
19.	Torres JC, Oca CF, Garrison RN. Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. South Med J, 1983, 76(10): 1217-1221.
20.	Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA, 2018, 319(3): 255-265.
21.	Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA, 2018, 319(3): 241-254.
22.	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国成人教育协会医学继续教育专业委员会肥胖代谢委员会. 腹腔镜Roux-en-Y胃旁路术规范化手术操作指南(2019版). 中华肥胖与代谢病电子杂志, 2019, 5(2): 63-69.
23.	王存川, 赵蕾. 减重外科新概念—精准腹腔镜胃旁路术. 中华胃肠外科杂志, 2014, 17(7): 631-634.
24.	Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y—500 patients: technique and results, with 3–60 month follow-up. Obes Surg, 2000, 10(3): 233-239.
25.	Aminian A, Chaudhry RM, Khorgami Z, et al. A challenge between trainee education and patient safety: does fellow participation impact postoperative outcomes following bariatric surgery?. Obes Surg, 2016, 26(9): 1999-2005.
26.	王文越, 杨珵璨, 王兵. 减重代谢手术治疗重度肥胖合并2型糖尿病术后1年疗效分析. 腹腔镜外科杂志, 2018, 23(1): 12-16.
27.	杨珵璨, 王文越, 于雯雯, 等. 减重代谢手术治疗肥胖合并中重度阻塞性睡眠呼吸暂停低通气综合征术后2年疗效分析. 中国实用外科杂志, 2022, 42(5): 596-600.
28.	Mahawar K, Sharples AJ, Graham Y. A systematic review of the effect of gastric pouch and/or gastrojejunostomy (stoma) size on weight loss outcomes with Roux-en-Y gastric bypass. Surg Endosc, 2020, 34(3): 1048-1060.
29.	Haghighat N, Kamran H, Moaddeli MN, et al. The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass. Ann Med Surg (Lond), 2022, 84: 104914. doi: 10.1016/j.amsu.2022.104914.
30.	Kamocka A, Chidambaram S, Erridge S, et al. Length of biliopancreatic limb in Roux-en-Y gastric bypass and its impact on post-operative outcomes in metabolic and obesity surgery-systematic review and meta-analysis. Int J Obes (Lond), 2022, 46(11): 1983-1991.
31.	Eagleston J, Nimeri A. Optimal small bowel limb lengths of Roux-en-Y gastric bypass. Curr Obes Rep, 2023, 12(3): 345-354.
32.	Salte OBK, Svanevik M, Risstad H, et al. Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m²: 5-year outcomes of a double-blind, randomized clinical trial. BJS Open, 2021, 5(6): zrab105. doi: 10.1093/bjsopen/zrab105.
33.	Fakas S, Elias M, Lim D, et al. Comparison of gastrojejunostomy techniques and anastomotic complications: a systematic literature review. Surg Endosc, 2021, 35(12): 6489-6496.
34.	Rondelli F, Bugiantella W, Desio M, et al. Antecolic or retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Obes Surg, 2016, 26(1): 182-195.
35.	Rahimi AO, Ashouri Y, Maegawa F, et al. Robotic bariatric surgery in older adults, is it safer than the laparoscopic approach? A 7-year analysis of Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Obes Surg, 2023, 33(9): 2671-2678.
36.	El Chaar M, Petrick A, Clapp B, et al. Outcomes of robotic-assisted bariatric surgery compared to standard laparoscopic approach using a standardized definition: first look at the 2020 Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) data. Obes Surg, 2023, 33(7): 2025-2039.

1. Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am, 1967, 47(6): 1345-1351.
2. Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg, 1994, 4(4): 353-357.
3. Varela JE, Nguyen NT. Laparoscopic sleeve gastrectomy leads the U. S. utilization of bariatric surgery at Academic Medical Centers. Surg Obes Relat Dis, 2015, 11(5): 987-990.
4. 大中华减重与代谢手术数据库研究者团队. 大中华减重与代谢手术数据库2022年度报告. 中国实用外科杂志, 2023, 43(5): 540-551.
5. Salminen P, Grönroos S, Helmiö M, et al. Effect of laparoscopic sleeve gastrectomy vs Roux-en-Y gastric bypass on weight loss, comorbidities, and reflux at 10 years in adult patients with obesity: the SLEEVEPASS randomized clinical trial. JAMA Surg, 2022, 157(8): 656-666.
6. 中华医学会外科学分会甲状腺及代谢外科学组, 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 中国肥胖及2型糖尿病外科治疗指南(2019版). 中国实用外科杂志, 2019, 39(4): 301-306.
7. Henrikson V. Can small bowel resection be defended as therapy for obesity?. Obes Surg, 1994, 4(1): 54. doi: 10.1381/096089294765558926.
8. Kremen AJ, Linner JH, Nelson CH. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg, 1954, 140(3): 439-448.
9. Payne JH, Dewind LT, Commons RR. Metabolic observations in patients with jejunocolic shunts. Am J Surg, 1963, 106: 273-89.
10. Bray GA. Current status of intestinal bypass surgery in the treatment of obesity. Diabetes, 1977, 26(11): 1072-1079.
11. Hocking MP, Duerson MC, O’Leary JP, et al. Jejunoileal bypass for morbid obesity. Late follow-up in 100 cases. N Engl J Med, 1983, 308(17): 995-999.
12. Griffen WO Jr, Bivins BA, Bell RM. The decline and fall of the jejunoileal bypass. Surg Gynecol Obstet, 1983, 157(4): 301-308.
13. Singh D, Laya AS, Clarkston WK, et al. Jejunoileal bypass: a surgery of the past and a review of its complications. World J Gastroenterol, 2009, 15(18): 2277-2279.
14. DeWind LT, Payne JH. Intestinal bypass surgery for morbid obesity: long-term results. JAMA, 2014, 312(9): 966. doi: 10.1001/jama.2014.10853.
15. Bray GA, Barry RE, Benfield JR, et al. Intestinal bypass surgery for obesity decreases food intake and taste preferences. Am J Clin Nutr, 1976, 29(7): 779-783.
16. Mason EE, Ito C. Gastric bypass. Ann Surg, 1969, 170(3): 329-339.
17. Griffen WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg, 1977, 186(4): 500-509.
18. Buckwalter JA. A prospective comparison of the jejunoileal and gastric bypass operations for morbid obesity. World J Surg, 1977, 1(6): 757-768.
19. Torres JC, Oca CF, Garrison RN. Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature. South Med J, 1983, 76(10): 1217-1221.
20. Peterli R, Wölnerhanssen BK, Peters T, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in patients with morbid obesity: the SM-BOSS randomized clinical trial. JAMA, 2018, 319(3): 255-265.
21. Salminen P, Helmiö M, Ovaska J, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS randomized clinical trial. JAMA, 2018, 319(3): 241-254.
22. 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会, 中国成人教育协会医学继续教育专业委员会肥胖代谢委员会. 腹腔镜Roux-en-Y胃旁路术规范化手术操作指南(2019版). 中华肥胖与代谢病电子杂志, 2019, 5(2): 63-69.
23. 王存川, 赵蕾. 减重外科新概念—精准腹腔镜胃旁路术. 中华胃肠外科杂志, 2014, 17(7): 631-634.
24. Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y—500 patients: technique and results, with 3–60 month follow-up. Obes Surg, 2000, 10(3): 233-239.
25. Aminian A, Chaudhry RM, Khorgami Z, et al. A challenge between trainee education and patient safety: does fellow participation impact postoperative outcomes following bariatric surgery?. Obes Surg, 2016, 26(9): 1999-2005.
26. 王文越, 杨珵璨, 王兵. 减重代谢手术治疗重度肥胖合并2型糖尿病术后1年疗效分析. 腹腔镜外科杂志, 2018, 23(1): 12-16.
27. 杨珵璨, 王文越, 于雯雯, 等. 减重代谢手术治疗肥胖合并中重度阻塞性睡眠呼吸暂停低通气综合征术后2年疗效分析. 中国实用外科杂志, 2022, 42(5): 596-600.
28. Mahawar K, Sharples AJ, Graham Y. A systematic review of the effect of gastric pouch and/or gastrojejunostomy (stoma) size on weight loss outcomes with Roux-en-Y gastric bypass. Surg Endosc, 2020, 34(3): 1048-1060.
29. Haghighat N, Kamran H, Moaddeli MN, et al. The impact of gastric pouch size, based on the number of staplers, on the short-term weight outcomes of Roux-en-Y gastric bypass. Ann Med Surg (Lond), 2022, 84: 104914. doi: 10.1016/j.amsu.2022.104914.
30. Kamocka A, Chidambaram S, Erridge S, et al. Length of biliopancreatic limb in Roux-en-Y gastric bypass and its impact on post-operative outcomes in metabolic and obesity surgery-systematic review and meta-analysis. Int J Obes (Lond), 2022, 46(11): 1983-1991.
31. Eagleston J, Nimeri A. Optimal small bowel limb lengths of Roux-en-Y gastric bypass. Curr Obes Rep, 2023, 12(3): 345-354.
32. Salte OBK, Svanevik M, Risstad H, et al. Standard versus distal Roux-en-Y gastric bypass in patients with BMI 50–60 kg/m²: 5-year outcomes of a double-blind, randomized clinical trial. BJS Open, 2021, 5(6): zrab105. doi: 10.1093/bjsopen/zrab105.
33. Fakas S, Elias M, Lim D, et al. Comparison of gastrojejunostomy techniques and anastomotic complications: a systematic literature review. Surg Endosc, 2021, 35(12): 6489-6496.
34. Rondelli F, Bugiantella W, Desio M, et al. Antecolic or retrocolic alimentary limb in laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Obes Surg, 2016, 26(1): 182-195.
35. Rahimi AO, Ashouri Y, Maegawa F, et al. Robotic bariatric surgery in older adults, is it safer than the laparoscopic approach? A 7-year analysis of Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database. Obes Surg, 2023, 33(9): 2671-2678.
36. El Chaar M, Petrick A, Clapp B, et al. Outcomes of robotic-assisted bariatric surgery compared to standard laparoscopic approach using a standardized definition: first look at the 2020 Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) data. Obes Surg, 2023, 33(7): 2025-2039.

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Laparoscopic Roux-en-Y gastric bypass：from history to precise and specification

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