Laparoscopic Jejunal Sleeve: A Simple and Ideal New Technique for Revision of Roux-en-Y Gastric Bypass After Weight Regains Technical Aspects


Revision of gastric bypasses that fail is one of the most difficult challenges that face bariatric surgeons these days. Adding a foreign body like a band or a silastic may give unsatisfactory results, while increasing malabsorption may result in severe malnutrition and hypoproteinemia. Laparoscopic jejunal sleeve is based on the principles of laparoscopic sleeve gastrectomy applied to a failed Roux-en-Y gastric bypass. The procedure is simple and involves only stapling, is reproducible, accessible, effective, and safe, without foreign bodies. Weight loss may be achieved to give an extra 5 to 10 points of BMI reduction. Early complications are similar to laparoscopic sleeve gastrectomy and may involve leaks and strictures. Mid- and long-term weight loss data are lacking at the present time, and patients should be selected based on an initial response to their gastric bypass.



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