Obesity surgery
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Comparative Study
Effect of laparoscopic versus open gastric bypass surgery on postoperative pain and bowel function.
This study was designed to assess postoperative pain and bowel function in morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGBP) performed either by open or laparoscopic technique. ⋯ The laparoscopic RYGBP operation was associated with less postoperative pain and morphine consumption than the open RYGBP, thereby facilitating an earlier recovery of intestinal motility.
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Recent national efforts have focused on improving patient safety in surgical procedures including examining adverse events. An adverse event in laparoscopic Roux-en-Y gastric bypass (LRYGBP) which has not received much scrutiny involves orogastric tube complications during gastric pouch formation. ⋯ Orogastric tube complications can occur during laparoscopic RYGBP, but are seldom reported and can be associated with significant morbidity. Treatment options are dependent upon the situation. More importantly, prevention strategies must include constant communication with the anesthesiologist and removal or manipulation of an OGT prior to stapling or suturing, use of large bore OGTs for increased visual or tactile recognition, retraction of the OGT proximal to the anastomosis during gastrojejunal construction and employing alternatives to esophageal temperature probes (i.e. Foley temperature probes).