INTRODUCTION: Bariatric surgery has evolved into multiple forms in the last decades, combining food restriction and malabsorption. The aim of this study was to develop a new technique based on food restriction and early stimulation of the distal gut, thus maintaining the alimentary tract continuity. METHODS: Thirty-two Yorkshire pigs, weight 22.2 +/- 5.4 kg (mean +/- SD) were randomly assigned to four laparoscopic procedures: ileal transposition (IT, n = 8); sleeve gastrectomy with ileal transposition (SGIT, n = 8); Roux-en-Y gastric bypass (GBP, n = 8); sham operation (SHAM, n = 8). Firing 45-mm linear staplers over a 60-F bougie, resecting the greater curvature and fundus, constituted a sleeve gastrectomy. Ileal transposition was performed by isolating a 100-cm ileal segment proximal to the ileocecal valve and by dividing the proximal jejunum 15 cm distal to the ligament of Treitz and performing re-anastomosis. Gastric bypass consisted of creating a proximal gastric pouch and a 300 cm alimentary limb. Sham operation was performed by bowel transections and re-anastomosis in the ileum and proximal jejunum together with gastrotomy and closure. Animals were evaluated weekly for weight increase and food intake. We performed a logistic regression analysis to compare weight progression curves, and analysis of variance (ANOVA) and Bonferroni (Dunn) tests to detect differences in weight and food intake. RESULTS: We observed significant differences in mean weight after 18 weeks between SGIT (30.9 +/- 13.4 kg) and SHAM (72.5 +/- 10.7 kg) (p = 0.0002), and GBP (28.6 +/- 2.5 kg) and SHAM (p = 0.0001), and IT (56.1 +/- 13.4 kg) and SHAM (p = 0.0081). No differences were observed between RYGB and SGIT. We also observed significant differences in food intake (grams per day) in the third month between SGIT (1668 +/- 677 g) versus SHAM (3252 +/- 476 g) (p = 0.0006), and GBP (2011 +/- 565 g) versus SHAM (p = 0.039). No differences were observed in food intake between SGIT and GBP. CONCLUSION: SGIT proved to be as effective in the short term as GBP on weight progression with no bypass of the proximal gut.
INTRODUCTION: Bariatric surgery has evolved into multiple forms in the last decades, combining food restriction and malabsorption. The aim of this study was to develop a new technique based on food restriction and early stimulation of the distal gut, thus maintaining the alimentary tract continuity. METHODS: Thirty-two Yorkshire pigs, weight 22.2 +/- 5.4 kg (mean +/- SD) were randomly assigned to four laparoscopic procedures: ileal transposition (IT, n = 8); sleeve gastrectomy with ileal transposition (SGIT, n = 8); Roux-en-Y gastric bypass (GBP, n = 8); sham operation (SHAM, n = 8). Firing 45-mm linear staplers over a 60-F bougie, resecting the greater curvature and fundus, constituted a sleeve gastrectomy. Ileal transposition was performed by isolating a 100-cm ileal segment proximal to the ileocecal valve and by dividing the proximal jejunum 15 cm distal to the ligament of Treitz and performing re-anastomosis. Gastric bypass consisted of creating a proximal gastric pouch and a 300 cm alimentary limb. Sham operation was performed by bowel transections and re-anastomosis in the ileum and proximal jejunum together with gastrotomy and closure. Animals were evaluated weekly for weight increase and food intake. We performed a logistic regression analysis to compare weight progression curves, and analysis of variance (ANOVA) and Bonferroni (Dunn) tests to detect differences in weight and food intake. RESULTS: We observed significant differences in mean weight after 18 weeks between SGIT (30.9 +/- 13.4 kg) and SHAM (72.5 +/- 10.7 kg) (p = 0.0002), and GBP (28.6 +/- 2.5 kg) and SHAM (p = 0.0001), and IT (56.1 +/- 13.4 kg) and SHAM (p = 0.0081). No differences were observed between RYGB and SGIT. We also observed significant differences in food intake (grams per day) in the third month between SGIT (1668 +/- 677 g) versus SHAM (3252 +/- 476 g) (p = 0.0006), and GBP (2011 +/- 565 g) versus SHAM (p = 0.039). No differences were observed in food intake between SGIT and GBP. CONCLUSION: SGIT proved to be as effective in the short term as GBP on weight progression with no bypass of the proximal gut.
Authors: Mark A Cohen; Sandra M Ellis; Carel W Le Roux; Rachel L Batterham; Adrian Park; Michael Patterson; Gary S Frost; Mohammad A Ghatei; Stephen R Bloom Journal: J Clin Endocrinol Metab Date: 2003-10 Impact factor: 5.958
Authors: Gema Frühbeck; Alberto Diez-Caballero; M Jesús Gil; Inés Montero; Javier Gómez-Ambrosi; Javier Salvador; Javier A Cienfuegos Journal: Obes Surg Date: 2004-05 Impact factor: 4.129
Authors: Chiao-Chien Connie Hung; Fraser Pirie; Jian'an Luan; Emma Lank; Ayesha Motala; Giles S H Yeo; Julia M Keogh; Nicholas J Wareham; Stephen O'Rahilly; I Sadaf Farooqi Journal: Diabetes Date: 2004-09 Impact factor: 9.461
Authors: Catherine L Dakin; Caroline J Small; Rachel L Batterham; Nicola M Neary; Mark A Cohen; Michael Patterson; Mohammad A Ghatei; Stephen R Bloom Journal: Endocrinology Date: 2004-03-04 Impact factor: 4.736
Authors: Rachel L Batterham; Mark A Cohen; Sandra M Ellis; Carel W Le Roux; Dominic J Withers; Gary S Frost; Mohammad A Ghatei; Stephen R Bloom Journal: N Engl J Med Date: 2003-09-04 Impact factor: 91.245
Authors: Gianmattia del Genio; Michel Gagner; David Nocca; Federico Cuenca-Abente; Laurent Biertho; Anne Waage; Barbara Faife; Federica del Genio; Camilo Boza; Rajesh Aggarwal; Alberto Del Genio Journal: Obes Surg Date: 2008-05-28 Impact factor: 4.129
Authors: Gianmattia Del Genio; Michel Gagner; Federico Cuenca-Abente; David Nocca; Laurent Biertho; Federica Del Genio; Ahmad Assalia; Alberto Del Genio Journal: Obes Surg Date: 2008-06-18 Impact factor: 4.129
Authors: Rohit Kohli; Michelle Kirby; Kenneth D R Setchell; Pinky Jha; Kori Klustaitis; Laura A Woollett; Paul T Pfluger; William F Balistreri; Patrick Tso; Ronald J Jandacek; Stephen C Woods; James E Heubi; Matthias H Tschoep; David A D'Alessio; Noah F Shroyer; Randy J Seeley Journal: Am J Physiol Gastrointest Liver Physiol Date: 2010-07-01 Impact factor: 4.052
Authors: Lee D Ying; Gregory A Breuer; Matthew O Hubbard; Geoffrey S Nadzam; John Hwa; Kathleen A Martin Journal: Obes Surg Date: 2019-02 Impact factor: 4.129