Clinical Study of Laparoscopic Non Banded Vertical Gastroplasty in Bariatric Surgery

Laparoscopic Non Banded Vertical (Magenstrasse and Mill) Gastroplasty In Bariatric Surgery. Morbidity and Results on Weight Loss and Associated Co-morbidities

Evaluation of the laparoscopic approach of the Magenstrasse and Mill procedure in a prospective study of 100 patients

The laparoscopy is performed under general anesthesia with a 5 ports access under 14mm Hg pressure. After opening of the gastrocolic ligament and division of any adhesions between stomach and pancreas a circular opening is performed at the junction of corpus and antrum of the stomach with a circular stapler. A tubular gastric pouch is then created along a calibration tube at the lesser curvature by a vertical stapling starting from the circular opening to the angle of Hiss.

Inclusion Criteria:

• Assessment by a multidisciplinary team specialized in bariatric and metabolic surgery including surgeon, endocrinologist, psychologist and/or psychiatrist, dietician
• BMI>40
• BMI>35 with diabetes or sleep apnea syndrome or hypertension treated with 3 drugs for at least one year
• Male or female patients between 18 and 75 years of age; fertile female patients must use a reliable contraception method;
• No previous bariatric procedure
• Informed consent given by patient

Exclusion Criteria:

• Medical contra-indication for a general anesthesia, or abdominal surgery (allergies to anesthetic drugs, cardio-vascular, pulmonary, or renal conditions leading to an unacceptable risk for the procedure
• Psychological-Psychiatric (boulimia, severe depression, psychotic condition)
• Non stabilized endocrine disorder, with potential interference on weight and/or diabetic condition
• Unability to understand goal of the study, plan of treatment and follow-up
• Large hiatal hernia and/or severe esophageal reflux disease
• Grazer, Sweet eater behavior