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Open Access Letter to the Editor

Safety and effectiveness of bariatric surgery: Roux-en-y gastric bypass is superior to gastric banding in the management of morbidly obese patients: a reply to the response by Bhoyrul et al

Ulrich Guller12, Lazar V Klein1 and John A Hagen1*

Author Affiliations

1 Center for Excellence in Bariatric Surgery, Humber River Regional Hospital Finch Site, University of Toronto, Department of Surgery, Toronto, ON, M3N 1N1, Canada

2 Department of Surgery, Division of Visceral Surgery and Transplantation, Inselspital, University of Bern, 3010 Bern, Switzerland

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Patient Safety in Surgery 2009, 3:20  doi:10.1186/1754-9493-3-20

Published: 19 August 2009

Abstract

Background

We have read the letter by Bhoyrul et al. in response to our recently published article "Safety and effectiveness of bariatric surgery: Roux-en-Y gastric bypass is superior to gastric banding in the management of morbidly obese patients". We strongly disagree with the content of the letter.

Results and discussion

Bhoyrul et al. base their letter mostly on low level evidence such as single-institutional case series (level IV evidence) and expert opinion (level V evidence). Surprisingly, they do not comment on the randomized controlled trial, which clearly favours gastric bypass over gastric banding.

Conclusion

The letter by Bhoyrul et al. is based on low level evidence and is itself biased, unsubstantiated, and not supported by the current literature.