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