Medical Journal of the Islamic Republic Of Iran

en Laparoscopic Sleeve Gastrectomy with Roux en-Y Bypass (A Novel Modification) for Morbid Obesity: A Prospective Observational Study Surgery Surgery Original Research Original Research Background: Recently, obesity witnessed a dramatic increase and its related comorbidities have grown. Bariatric surgeries were developed to reduce weight. However, all techniques had their advantages and shortages. In this work, we aimed to assess our new modification of combining sleeve gastrectomy with Roux en-y bypass for the management of obesity, hoping to gain benefits from both techniques to increase the excess bodyweight loss (EBW%).    Methods: The study was a prospective observational study on 23 Morbidly obese patients. The study was held from January 2020 to April 2022. The recruited patients were submitted to detailed clinical assessment and investigations to check fitness for surgery. Besides operative data, any intra- or post-operative complications were recorded. Each patient was followed up for at least one year.  The follow-up visits were scheduled at regular intervals (one week, one month, six months, and twelve months).    Results: The mean operative time was 113.91 minutes (65-150). No intraoperative complications or conversion. There was intraluminal bleeding in one patient within 48 hours postoperatively with successful conservative management. There was a complete cure of diabetes mellitus (DM) for 5, 2, and 3 patients and antidiabetic drugs were reduced for 64.3%, 21.43%, and 7.14% at 1, 6, and 12 months follow up respectively. Hypertension was cured in 1,1,2 patients, and antihypertensives were reduced for 2,1,1 patient, at 1, 6, and 12 months follow up respectively. EWL% was 14.4%, 40.78%, and 73.74% at 1,6,12 months follow up respectively. Hemoglobin concentration and ionized calcium improved over time. Finally, serum albumin at 1, 6, and 12 months follow-up was 3.64, 3.58, 3.78 g/dL respectively.    Conclusion: New modifications of combining LSG and LRYGB have shown to be safe and effective procedures. In addition, it is associated with minimal postoperative nutritional complications and permits complete visualization of the biliary system using endoscopy.   Laparoscopy, Bariatric Surgery, Roux en-Y, Obesity, Estimated weight loss 944 949 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-8222-3&slc_lang=en&sid=1 Ayman M Elwan dr_aymanelwan@mail.com 200319475328460080659 200319475328460080659 Yes Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Mohamed Naroz dr_naroz@yahoo.com 200319475328460080660 200319475328460080660 No Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Mohamed Eid Abdelrahman Eid dr_m_eid77@yahoo.com 200319475328460080661 200319475328460080661 No Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Mohamed Elsaed Abo Elkher drpms17@gmail.com 200319475328460080662 200319475328460080662 No Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Abd-Alhamed Hifny aHefny@usa.com 200319475328460080663 0009-0008-0214-6886 No Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Masoud Kh. El-Syed Ibrahim masoudkhibrahim@gmail.com 200319475328460080664 200319475328460080664 No Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt Lotfy Abdelsattar Ebrahim drlotfy_abdelsattar@yahoo.com 200319475328460080665 200319475328460080665 No Department of General Surgery, Faculty of Medicine, Al-Azhar University, Cairo, Egypt Mohmed Bakheet Gaber Bakheet mohamedbakheet189@yahoo.com 200319475328460080666 200319475328460080666 No Department of General Surgery, Faculty of Medicine, Al-Azhar University, Assiut, Egypt Ahmed Mahmoud Hussein amhmk1511@gmail.com 200319475328460080667 0009-0000-4225-5333 No General Surgery Department, Kasralainy School of Medicine, Cairo University, Cairo, Egypt Mahmoud Helmy Elsaied Hussein m.h973@yahoo.com 200319475328460080668 200319475328460080668 No Forensic Medicine and Clinical Toxicology, Damietta, Faculty of Medicine, Al-Azhar University, Damietta, Egypt