Obesity Surgery

, Volume 29, Issue 1, pp 304–305 | Cite as

What Is the Current Evidence to Define the Length of the Alimentary Limb in the Laparoscopic Gastric Bypass Technique?

  • Jesús Morales-MazaEmail author
  • Oscar Santes
Letter to the Editor

Dear Editor,

We read the article by Dr. Jiadi Gan, et al. [1] with substantial interest. We want to congratulate the authors for trying to solve one of the central debates on the surgical technique of laparoscopic gastric bypass (LGBP) for the treatment of obesity. Although there are high-quality studies, to date, it has not been possible to obtain a solid conclusion regarding the optimal length of the alimentary limb [2].

If we analyze the contemporary scientific evidence, we can only count on four randomized trials to date.

The first study published on the length of the alimentary limb was in 1992, during the era of open gastric bypass [3]. It was a long-term randomized prospective study. Two groups were studied, one with alimentary limb length of 150 cm (n = 23) and another group with an alimentary limb of 75 cm (n = 22). The follow-up was 43 ± 17 months. Weight loss was significantly higher at 24 and 36 months of follow-up in the “long” alimentary limb group compared to the...



laparoscopic gastric bypass


Compliance with Ethical Standards

Conflict of Interest

The author declares that there is no conflict of interest.

Statement on Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed Consent

Not applicable.

Ethical Approval

Not applicable.


  1. 1.
    Gan J, Wang Y, Zhou X. Whether a short or long alimentary limb influences weight loss in gastric bypass: a systematic review and meta-analysis. Obes Surg. 2018;28:3701–10.CrossRefGoogle Scholar
  2. 2.
    Orci L, Chilcott M, Huber O. Short versus long Roux-limb length in Roux-en-Y gastric bypass surgery for the treatment of morbid and super obesity: a systematic review of the literature. Obes Surg. 2011;21(6):797–804.CrossRefGoogle Scholar
  3. 3.
    Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the super obese. A prospective randomized study. Ann Surg. 1992;215(4):387–95.CrossRefGoogle Scholar
  4. 4.
    Choban PS, Flancbaum L. The effect of Roux limb lengths on outcome after Roux-en-Y gastric bypass: a prospective, randomized clinical trial. Obes Surg. 2002;12(4):540–5.CrossRefGoogle Scholar
  5. 5.
    Inabnet WB, Quinn T, Gagner M, et al. Laparoscopic Roux-en-Y gastric bypass in patients with BMI <50: a prospective randomized trial comparing short and long limb lengths. Obes Surg. 2005;15(1):51–7.CrossRefGoogle Scholar
  6. 6.
    Svanevik M, Risstad H, Hofsø D, et al. Perioperative outcomes of proximal and distal gastric bypass in patients with BMI ranged 50-60 kg/m(2)--a double-blind, randomized controlled trial. Obes Surg. 2015;25(10):1788–95.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryInstituto Nacional de Ciencias Médicas y Nutrición Salvador ZubiránMexico CityMexico

Personalised recommendations