Case report
Laparoscopic sleeve gastrectomy with ileal interposition (“neuroendocrine brake”)—pilot study of a new operation

https://doi.org/10.1016/j.soard.2006.03.005Get rights and content

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Methods

Between November 2003 and March 2005, the laparoscopic neuroendocrine brake procedure was performed in 19 patients (15 women and 4 men), with a mean age of 37.3 years (range 21–54) and a mean BMI of 40.2 kg/m2 (range 35–44). All 19 patients had at least one co-morbidity (Table 1).

The inclusion criteria conformed to the 1991 National Institutes of Health Consensus Development Panel on bariatric surgery [10]. The exclusion criteria included a history of upper abdominal surgery, age <18 years or

Results

Nineteen patients underwent laparoscopic sleeve gastrectomy and were followed up a mean of 11.6 months (range 1–17). The mean operating time was 197 minutes (range 170–265). No conversions to open surgery were required. The only intraoperative complication was a stapler malfunction in 1 case, resulting in leakage of gastric contents into the abdominal cavity, subsequently leading to pleural effusion. Intestinal function recovered after an average of 72 hours. Early postoperative complications

Discussion

This is the first description of laparoscopic ileal interposition plus sleeve gastrectomy, which we term the “neuroendocrine brake” operation, in 19 severely obese patients with manifest co-morbidities. Our preliminary and early results imply that the safety and efficacy of the procedure are equivalent to our own results in similar patients undergoing laparoscopic Roux-en-Y gastric bypass, an operation of comparable difficulty.

We hypothesize that this operation might have significant advantages

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