Background

Obese teenagers refuse that part of their body should be removed during surgery, others also fear sleeve gastrectomy complications. Objective: The idea is to combine gastric plication with single loop Gastric antral anastomosis to the ileum (Bi-partition) for obese teenagers, then observe weight loss and co-morbidity.

Methods

Overweight teenagers of BMI >30, who (or parents) refused other bariatric procedures were subjected to the study. Greater gastric curve was dissected, instead of using staplers, interrupted sutures 2/0 round needle was used in the inner row, prolene 2/0 round in continuous mode for the second row, leaving the antrum for the single loop anastomosis 3 cms wide, that was done with the ileum 230 cms distal to the duodeno-jejunal flexure.

Results

During 30 months ten teenagers were followed. mean age 15.7 +/- 3.8 , Hospital stay of one day. Excess weight loss quite comparable to sleeve gastrectomy, pre-operative weight was 97 +/- 23.7 kg that was reduced to 91.45+/- 13.6 k.gm after 3months, then to 83.3+/-11.9 k.gm in 6 months , further decrease to 75.8 + 12.7 k.gm after one year, more decrease after 18 months to 71.5 + 9.1 kg, still more decrease after 24 months to 67+ 7.8 kg . Only one case of post-operative leakage occurred that was at the site of entrotomies, suture closure was done on exploration.

Conclusions

Single anastomosis gastric plication ileal bypass, is a new promising modality for teenagers seeking low cost, safe, reversible and effective bariatric surgery.