Gastric bypass: Roux-en-Y gastrojejunostomy from the lesser curvature.

We describe a new technique for the surgical treatment of exogenous morbid obesity. The stomach is partitioned from the angle of His toward the lesser curvature, and a Roux-en-Y proximal jejunal limb drains the proximal gastric pouch, which is 25 to 35 ml in capacity. By use of the enteroanastomosis (EEA) or the intraluminal (ILS) stapling instrument for the gastrojejunostomy from the lesser curvature of the stomach, the functional reliability, vascular integrity, and ease of construction of the stoma have been improved. We performed the gastric bypass operation on 300 consecutive patients, 268 women and 32 men, over a two-year period beginning in June 1979. The patients' average admission weight was 126 kg. Diseases associated with obesity were observed in 57% of the patients, and concomitant operations were performed in 29%. The average weight loss at 6, 12, 18, and 24 months was 37.0, 48.5, 51.5, and 52.0 kg, respectively. Early and late complications occurred in 37 patients (12%), requiring 40 reoperations. Two deaths (0.6%) occurred within the 30 months' of observation.