- For the purpose of building best practice guidelines, an international expert panel was surveyed in 2014 and compared with the 2011 Sleeve Gastrectomy Consensus and with survey data culled from a general surgeon audience.
- Laparoscopic sleeve gastrectomy (LSG) has proved to be a safe and efficacious step or stand-alone surgical procedure for the treatment of morbid obesity. An increase in the body mass index and the accumulation of visceral fat are associated with a two- to threefold increased risk of developing reflux symptoms . Long-term complications appear to have a low incidence; however, in recent publications, gastroesophageal reflux disease (GERD) has been reported to occur in ≤27% of patients 6 years after the procedure.
- The number of laparoscopic Roux-en-Y gastric bypass (LRYGB) cases performed annually in the United States has significantly increased. With the increased number of laparoscopic cases in bariatric surgery, LRYGB has become one of the most technically demanding operations performed in minimally invasive surgery .
- The current laparoscopic mini-gastric bypass is a modification of the classic loop gastric bypass described by Mason and Ito . The original Mason and Ito loop gastric bypass consisted of a loop of proximal jejunum that was anastomosed to a small horizontal pouch of 100–150 cm3. The modification, as reported by Rutledge  and Rutledge and Walsh , consisted of a long, narrow, vertical gastric tube along the lesser curvature of the stomach that was connected to a loop of small bowel approximately 200 cm from the ligament of Treitz in an antecolic fashion.
- We present the case of a 47-year-old man who had undergone uneventful antecolic antegastric laparoscopic Roux-en-Y gastric bypass (LRYGB) in June 2002 for super morbid obesity. Ten months later, laparoscopic reduction of an internal hernia at the jejunojejunostomy was performed for an acute small bowel obstruction. Three months later, he underwent laparoscopic gastric pouch trimming for failure of weight loss, epigastric pain, marginal ulceration, and an increasing ability to tolerate larger food volumes with pouch dilation.