Magenstrasse and Mill vertical gastric stapling for morbid obesity

Background: The aim of the study was to determine the effects of a new vertical gastric stapling procedure used alone or in combination with a Roux-en-Y gastric bypass for patients with morbid obesity. Methods: A consecutive series of 100 patients with morbid obesity underwent either vertical gastric stapling alone (Magenstrasse and Mill procedure; MM) (n = 80) or combined with a limited Roux-en-Y gastric bypass (MM-GB) (n = 20). Median age (39 versus 40 years), body mass index (45·9 versus 45·8) and M: F ratio (1: 4 versus 1: 3) were similar between the two groups of patients. The median follow-up of patients who underwent the MM procedure was 36 (range 0–72) months, and 15 (0–36) months for patients who had the combined MM-GB procedure. Results: The operative mortality rate was 0 per cent and there were no major postoperataive complications. Median length of stay was 7 days for patients who had the MM procedure and 10 days for those who underwent combined MM-GB. One year after operation median(s.d.) weight loss was 38·6(15·1) kg in the MM group, compared with 50·4(8·4) kg in the MM-GB group (P = 0·02). Patients who had the MM procedure had lost 30(8·3) per cent of their original weight, compared with 36(3·2) per cent for those who had a combined MM-GB procedure (P = 0·03). Conclusion: Gastric stapling for morbid obesity is safe in specialized surgical units. Weight loss after the combined MM-GB procedure was greater than that following the MM procedure alone, although this has to be set against the potential long-term complications of a gastric bypass procedure. © 2001 British Journal of Surgery Society Ltd