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Background Bariatric surgery is a well-tolerated and effective treatment for severe obesity. Newer surgical techniques and equipment have improved safety standards surrounding bariatric surgery. In particular, buttressing of the staple line in sleeve gastrectomy has decreased rates of clinically significant postoperative bleeding. The present study investigates the effectiveness of buttressing the circular stapled anastomosis during laparoscopic Roux-en-Y gastric bypass (LRYGB). Setting Academic, accredited hospital. Methods A total of 253 patients undergoing LRYGB at a single academic institution were included in this retrospective study between 2014 and 2015. Buttressing material was used in 125 of these cases. Demographic information was collected from both groups preoperatively. Surgical characteristics were also obtained analyzed using unpaired t or χ 2 tests. Results Patients in both buttressing and nonbuttressing groups were on average 46 years old and predominantly female (79.2% versus 74.2% female, respectively), with a body mass index of approximately 48 kg/m 2 . Postoperative weight loss did not significantly differ between groups at any time point (buttressing versus nonbuttressing percentage of excess weight loss: 39.5% versus 41.5% at 3 mo, P = .3860; 56.4% versus 56.7% at 6 mo, P = .9341). There were no significant differences for operating time, length of stay, readmissions, or reoperations. Complications due to strictures were found to be lower for the buttressing group (0% buttressing versus 2.3% nonbuttressing, P = .0851). Specific rates of bleeding-related complications were significantly lower for the group in which buttressing was used (0% buttressing versus 3.1% nonbuttressing, P = .0463). Conclusion Buttressing of the gastrojejunal anastomosis during LRYGB significantly reduces bleeding-related complications and increases tolerability of the procedure.

The link between obesity and health disorders such as hypertension, diabetes and coronary artery disease is well known. When a morbidly obese patient presents with a new diagnosis of any cancer, it adds to the many challenges both the patient and treating physicians face. Not only is surgical resection of the malignancy more technically challenging, but also postoperative care such as therapeutic radiation and follow-up imaging is limited by the weight and size restrictions of the machines. With time to treatment being a key factor in limiting the progression of disease, standard weight loss techniques such as diet and exercise in the majority of cases take too long or fail to lead to adequate results. We present a case of a 48-year-old female with newly diagnosed papillary thyroid cancer who underwent gastric bypass surgery in order to lose enough weight to undergo radiation therapy to treat her metastatic disease.