Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI ≥ 60

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been shown to be safe and effective. There is little data on the outcomes in massively super-obese patients, with a body mass index (BMI) ≥60 kg/m² (super-super-obese). The goal of this study was to determine the safety and effectiveness of LRYGBP in these patients, and compare these results to patients with a BMI <60. Methods: 213 consecutive patients undergoing LRYGBP by a single surgeon at a university hospital were included in the study. The patients were divided into 2 groups: BMI <60 kg/m² (n=167) and BMI ≥60 kg/m² (n=46). The 2 groups were compared with regard to perioperative complications, and postoperative weight loss. Results: Both groups had statistically similar complication rates. There were major complications in 8 patients (5%) in the lower BMI group and in 3 patients (7%) in the higher BMI group. There were minor complications in 9 patients (5%) in the lower BMI group and in 4 patients (9%) in the higher BMI group. Mean percent excess weight loss (%EWL) was 64% at 1 year in the BMI < 60 group and 53% in the BMI ≥ 60 group. Conclusion: LRYGBP can be performed safely and effectively in super-super-obese patients (BMI ≥60). Although these patients have less %EWL than lighter patients, they still end up with a good result. Therefore, LRYGBP should be considered a good surgical option even for patients with a BMI ≥60.