What makes a gastric bypass a good gastric bypass? Opinion and hypothesis

Figure 1 Schematic diagram of Fobi Pouch Gastric Bypass.

Figure 2 Medium - long-term weight loss data for banded gastric bypass (Fobi Pouch), standard gastric bypass and Laparoscopic adjustable banding. Data from systematic review by O’Brien et al[10] 2006. (%EWL on the x axis refers to the percentage of pre-operative weight in excess of ideal body weight, which has been lost at any one point in time, shown on the y axis.

Figure 3 Schematic representations of possible configurations of gastric pouch. A: Shows a long narrow pouch based on the lesser curve; B: Shows a rather wider and shorter pouch based on the lesser curve; C: Shows a very small pouch formed by stapling just beyond the oesophago-gastric junction.

Figure 4 Operative photo showing the loose placement of a 6. 5 cm silastic ring proximal to the gastro-jejunal anastomosis.