Silastic ring vertical gastric bypass: cohort study with 83% rate of 5-year follow-up

Background: Silastic ring vertical gastric bypass (SRVGB) with jejunal interposition is our standard operation for morbidly obese patients. We present the results of 5 years of follow-up in a cohort of patients who underwent SRVGB in 2001. Methods: The records of all 160 consecutive patients who underwent SRVGB from January to December 2001 were reviewed. Of the 160 procedures, 143 were primary open cases, 14 were revisions from restrictive procedures, and 3 were laparoscopic cases. At 5 years, the body mass index and percentage of excess weight loss was available for 133 patients (83%) at office visits (n = 91, 68.4%), by telephone (n = 40, 30.1%), or by e-mail (n = 2, 1.5%). Results: Of the 160 patients, 121 were women and 39 were men, with a mean age of 33.15 +/- 10.0 years, percentage of ideal body weight of 195.7% +/- 40.8%, and body mass index of 44.6 +/- 9.3 ka/m(2). The mean hospital stay was 3 +/- 1 days. One patient (.6%) died of a pulmonary embolus. Early complications included 3 cases (1.87%) of upper gastrointestinal bleeding and 4 gastric leaks (2.5%): 2 (1.36%) from primary cases and 2 (14.29%) from revisional cases. Late complications included 32 patients (20%) with incisional hernias, 20 (12.5%) with anemia, 14 (8.8%) with dumping, 4 (2.5%) with gastrojejunal stricture, 2 (1.25%) with intestinal obstruction, and 2 (1.25%) requiring silastic ring surgical removal. The 5-year follow-up data were available for 133 patients (83%). The mean body mass index in this group was 27 +/- 5 kg/m(2), with a percentage of excess weight loss of 83% +/- 18.3% at 5 years postoperatively. Conclusion: The results of our study have shown that SRVGB is an effective operation for promoting lasting weight loss, with acceptable mortality and complication rates. (Surg Obes Relat Dis 2009;5:455-458.) (C) 2009 American Society for Metabolic and Bariatric Surgery. All rights reserved.