Laparoscopic Roux-en-Y gastric bypass for morbid obesity -- case report.

Morbid obesity is currently one of the leading problems worldwide. More than 1 of 5 adults in Croatia are considered obese, with a body mass index (BMI) higher than 30 kg/ m(2), with no sex differences. Indications for bariatric surgery are BMI >40 kg/m(2) or BMI >35 kg/m(2) with comorbidities. Bariatric procedures are divided into restrictive, malabsorptive, and combined procedures. The Roux-en-Y gastric bypass is a combined bariatric procedure, already being accepted as the standard one in the USA and gaining ground in Europe as well. A 47-year-old woman with BMI of 48.2 kg/m(2) (105.5 kg) was hospitalized at our department. Her increasing attempts to lose weight using conservative methods showed no success. She also suffered from glucose intolerance, gastritis, chronic obstructive pulmonary disease, hypertension and depression as comorbidities. Based on our experience in bariatric surgery (gastric banding, sleeve gastrectomy, duodenal switch), we decided for the first time in our hospital to perform laparoscopic Roux-en-Y gastric bypass. The patient was released on the fifth postoperative day with BMI of 40.56 kg/m(2) (100 kg body weight), excess weight loss 12.5%. One month after the procedure, her BMI was 38.54 kg/m(2), excess weight loss 23.92% (body weight 95 kg).