Obesity Surgery, 12, 559-563 © FD-Communications Inc. Obesity Surgery, 12, 2002 559 Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a popular operation for morbid obesity. Early complications can be treated success- fully with a laparoscopic approach. We reviewed our experience with laparoscopic re-exploration in the early postoperative period. Methods: The initial 85 patients who underwent LRYGBP by two surgeons at a training hospital were reviewed. All patients who required re-exploration within the first 60 days postoperatively were consid- ered. Results: Nine patients underwent ten laparoscopic explorations. Mean BMI was 50 kg/m 2 . One patient underwent revision for proximal anastomotic obstruction at 58 days postoperatively. Three patients developed obstruction at the level of the transverse mesocolon secondary to cicatrix and required laparoscopic release of the scar tissue. Two patients required revision of the jejuno-jejunostomy. Internal hernia through the mesenteric defect at the level of the transverse mesocolon was the cause of bowel obstruction in two patients. One patient underwent lysis of adhesions between the left colon and the transverse mesocolon at 6 days postopera- tively. One out of the ten laparoscopic re-explo- rations was negative for any findings. Eight patients recovered without further complications and one patient required endoscopic dilatations of the proxi- mal anastomosis. Conclusion: In the course of treating morbid obe- sity with laparoscopic intervention, complications will arise. Laparoscopic exploration for early compli- cations is a safe and feasible option. Key words: Morbid obesity, bariatric surgery, gastric bypass, laparoscopy, cicatrix, intestinal obstruction Introduction Roux-en-Y gastric bypass (RYGBP) has been established as an effective and durable operation for morbid obesity. Several studies have reported early weight reduction of 60-70% of excess body weight at 1 year. 1-3 The development of the less invasive laparoscopic technique to perform RYGBP by Wittgrove in 1994 increased the popu- larity of this procedure. 4 The complications after open RYGBP have been well described. 5-8 Laparoscopic RYGBP (LRYGBP) presents similar complications, although their incidence may vary because of the intrinsic technical differences. We describe our experience with management of com- plications following LRYGBP that occurred in the first 60 postoperative days. Methods Our 85 patients who underwent a LRYGBP in one teaching hospital were reviewed retrospectively. One patient underwent revision of a vertical banded gastroplasty to RYGBP laparoscopically. There were eight conversions. All conversions occurred early in the surgeons’ experience, within the first 13 cases. Demographic data reviewed included age, sex, preoperative body mass index (BMI) and co-morbidities. All complications, including those that required surgical repair, were considered. Operative time, estimated blood loss (EBL) and length of hospital stay (LOS) were reviewed. Laparoscopic Reoperation for Early Complications of Laparoscopic Gastric Bypass Pavlos K. Papasavas, MD; Michael S. O’Mara, MD; Robert F. Quinlin, MD; Julie Maurer, PA-C; Philip F. Caushaj, MD; Daniel J. Gagné, MD Temple University School of Medicine Clinical Campus at the Western Pennsylvania Hospital, Pittsburgh, PA, U.S.A. Presented at the 3rd International Symposium on Laparoscopic Obesity Surgery, Chania, Crete, Greece, September 5, 2001. Reprint requests to: Daniel Gagné, MD, The Western Pennsylvania Hospital, Department of Surgery, 4800 Friendship Avenue, Pittsburgh, PA 15224, USA. Fax: (412) 578-1434; e-mail: dgagne@wpahs.org This work was supported in part by a research grant from Tyco/United States Surgical Corporation.