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Anesthesia laparoscopic sleeve gastrectomy

Mordechai Shimonov, Pinhas Schechter, Mona Boaz, Ronen Waintrob, Tiberiu Ezri
BACKGROUND: The effect of body mass index (BMI) reduction following bariatric surgery on subsequent airway management has not been investigated. This study aimed to investigate the association between BMI reduction and airway assessment and management measured by Mallampati class (MC) and laryngoscopy grade (LG). METHODS: We conducted a retrospective study over 6 years to compare the BMI changes, MC and LG in patients having weight reduction bariatric surgery followed by subsequent surgery...
August 29, 2016: Obesity Surgery
Maciej Matłok, Piotr Major, Piotr Małczak, Michał Wysocki, Leif Hynnekleiv, Mateusz Nowak, Konrad Karcz, Michał Pędziwiatr, Andrzej Budzyński
INTRODUCTION    Obesity is a growing worldwide problem. One of the most effective treatments is a bariatric procedure; however, surgery is associated with the risk of complications, such as staple line leakage, suture line bleeding, and rhabdomyolysis (RML). OBJECTIVES    The objective of our study was to assess the risk of RML after bariatric surgery related to intravenous fluid administration in the perioperative period. PATIENTS AND METHODS    The study involved 194 patients who underwent a bariatric surgery (laparoscopic sleeve gastrectomy or laparoscopic gastric bypass)...
April 13, 2016: Polskie Archiwum Medycyny Wewnętrznej
Megana Ballal, Tracey Straker
Myasthenia gravis, a disorder of neuromuscular transmission, presents a unique challenge to the perioperative anesthetic management of morbidly obese patients. This report describes the case of a 27-year-old morbidly obese woman with a past medical history significant for myasthenia gravis and fatty liver disease undergoing bariatric surgery. Anesthesia was induced with intravenous agents and maintained with an inhalational and balanced intravenous technique. The nondepolarizing neuromuscular blocker Cisatracurium was chosen so that no reversal agents were given...
2015: Case Reports in Medicine
Wei-Chun Hung, Wei-Hung Chen, Yu-Hsuan Shih, Kuo-Chuan Hung
BACKGROUND: Rapid and uneventful postoperative recovery following general anesthesia in morbidly obese patients undergoing bariatric surgery may offer challenges to anesthesiologists. With improved surgical techniques and shorter pneumoperitoneum, regional anesthesia may be considered for this laparoscopic procedure in selected cases. CASE DESCRIPTION: The first patient was a 60-year-old male (body mass index: 39 kg/m(2)) who was scheduled for laparoscopic sleeve gastrectomy...
2015: SpringerPlus
Youn Yi Jo, Ji Young Kim, Chun Kon Park, Young Jin Chang, Hyun Jeong Kwak
BACKGROUND: We investigated the effect of prolonged inspiratory to expiratory (I/E) ratio ventilation on respiratory mechanics, gas exchange, and regional cerebral oxygen saturation (rSO2) in obese patients undergoing laparoscopic bariatric surgery in the reverse Trendelenburg position. METHODS: Twenty-eight adult patients scheduled for laparoscopic sleeve gastrectomy were enrolled in this prospective observational study. After anesthesia induction, pressure-controlled ventilation was conducted initially at a conventional I/E ratio of 1:2 and a positive end-expiratory pressure of 5 cmH2O...
February 2016: Obesity Surgery
Sunil Rajan, Harindran Narendran, Susamma Andrews
CONTEXT: The favorable kinetic properties of sevoflurane could be advantageous in obese patients undergoing bariatric surgery, improving recovery from general anesthesia (GA). AIMS: To compare the recovery criteria following anesthesia with sevoflurane and isoflurane in morbidly obese patients undergoing laparoscopic gastric sleeve resection. SETTINGS AND DESIGN: This was a prospective randomized controlled study conducted in 50 patients undergoing laparoscopic sleeve gastrectomy...
May 2014: Anesthesia, Essays and Researches
Tamer H Ibrahim, Gamal T Yousef, Ali M Ali Hasan, Hossam I Eldesuky
BACKGROUND: Morbid obesity magnifies the importance of the fat-blood solubility coefficient of the anesthetic in its relation to emergence and recovery. Using bispectral index (BIS) monitoring for the titration of the administration of inhaled anesthetics such as desflurane may permit a less consumption and more rapid recovery from desflurane anesthesia in morbidly obese patients, which enables earlier maintenance of a patent airway, better protection against aspiration, and better oxygenation...
January 2013: Anesthesia, Essays and Researches
Alvina Mushtaq, Janelle D Vaughns, Victoria C Ziesenitz, Evan P Nadler, John N van den Anker
BACKGROUND: Obese patients have a higher risk of venous thromboembolism when immobilized due to surgery. The objective of this study was to assess anti-factor Xa activity in adolescent bariatric surgical patients receiving prophylactic enoxaparin. METHODS: Four morbidly obese adolescents undergoing laparoscopic sleeve gastrectomy were enrolled. Enoxaparin was administered (40 mg subcutaneous (SC) if BMI ≤50 kg/m(2) or 60 mg SC if BMI >50 kg/m(2)) for prevention of venous thromboembolism every 12 h starting after induction of anesthesia until discharge...
October 2015: Obesity Surgery
Amit Lehavi, Olga Sandler, Ahmad Mahajna, Abraham Weissman, Yeshayahu Shai Katz
BACKGROUND: Rhabdomyolysis is a relatively uncommon, severe complication of anesthesia and surgery in the morbidly obese. As the use of propofol-based anesthesia has been associated with an increased risk of rhabdomyolysis and metabolic acidosis, this pilot study was designed to assess the effect of propofol anesthesia on the incidence of rhabdomyolysis in morbidly obese patients undergoing bariatric surgery. METHODS: Thirty, morbidly obese patients (body mass index 43 ± 3 kg/m(2)) scheduled for bariatric laparoscopic sleeve gastrectomy were randomized to receive either propofol (P) or inhalational anesthetic (I)-based balanced general anesthesia...
October 2015: Obesity Surgery
R Badaoui, L Rebibo, V Thiel, C Perret, I Popov, A Dhahri, J-M Regimbeau, P Verhaeghe, H Dupont
UNLABELLED: The development of outpatient surgery is one of the major goals of the public health policy in 2010. The purpose of this observational study is to evaluate the feasibility of the laparoscopic sleeve gastrectomy (LSG) in ambulatory. METHODS: This prospective observational study was conducted from May 2011 to June 2013. The procedure was proposed for patients undergoing LSG who were predetermined inclusion criteria. Following preoxygenation, anaesthesia was induced with propofol and sufentanil...
September 2014: Annales Françaises D'anesthèsie et de Rèanimation
Marcel Autran Machado, Fabio F Makdissi, Rodrigo C Surjan
INTRODUCTION: Laparoscopic gastrointestinal resections using single-port are possible, but triangulation problems and the need of articulated instruments difficult the procedures. AIM: To present a surgical alternative using single-port laparoscopic device on gastric resection. TECHNIQUE: The patient is placed in a supine and reverse Trendelenburg position with surgeon between patient's legs. First assistant was on the right side of the patient with the monitor placed on the patient's cranial side...
April 2014: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Monika A Proczko, Pieter S Stepaniak, Marcel de Quelerij, Floor Haak van der Lely, J Frans Smulders, Lukasz Kaska, Mohammed A Soliman Hamad
BACKGROUND: In patients undergoing surgical interventions under general anesthesia, obstructive sleep apnea syndrome (OSA) can cause serious perioperative cardiovascular or respiratory complications leading to fatal consequences, even sudden death. In this study we test the hypothesis that morbidly obese patients diagnosed by a polysomnography test and using continuous positive airway pressure (CPAP) therapy have fewer and less severe perioperative complications and a shorter hospital stay than patients who have a medical history that meets at least three STOP-Bang criteria and are not using CPAP therapy...
December 2014: Journal of Anesthesia
Michal Barak, Ahmad Assalia, Ahmad Mahajna, Bishara Bishara, Alexander Braginski, Yoram Kluger
BACKGROUND: The population of obese patients is progressively growing and bariatric operations are becoming increasingly common. Morbidly obese patients require special anesthetic care and are often considered to be difficult to ventilate and intubate. The VivaSight™ Single Lumen tube is an endotracheal tube with a camera embedded in its tip. The view from the tip appears continuously on a monitor in the anesthesiologist's vicinity. The aim of this study was to assess the VivaSight™ in comparison with conventional endotracheal tube as an aid in the intubation and surveillance of tube position during surgery of obese patients...
2014: BMC Anesthesiology
M Cerci, M I Bellini, F Russo, D Benavoli, M Capperucci, A L Gaspari, P Gentileschi
Introduction. Moderate obesity (BMI 30-35 kg/m(2)) affects 25% of the western population. The role of bariatric surgery in this context is currently debated, reserved for patients with comorbidity, as an alternative to conservative medical treatment. We describe our experience in moderately obese patients treated with bariatric surgery. Materials and Methods. Between September 2011 and September 2012, 25 patients with grade I obesity and comorbidities underwent bariatric surgery: preoperative mean BMI 33...
2013: Gastroenterology Research and Practice
Mohamed Ahmed Mansour, Ahmed Abdelaal Ahmed Mahmoud, Mohammed Geddawy
OBJECTIVE: The objective of this study was to evaluate the efficacy and safety of giving general anesthesia without the use of any opioids either systemic or intraperitoneal in bariatric surgery. METHODS: Prospective randomized controlled trial. Obese patients (body mass index >50 Kg/m(2)) undergoing laparoscopic sleeve gastrectomies were recruited and provided an informed signed consent. Patients were randomized using a computer generated randomization table to receive either opioid or non-opioid based anesthesia...
October 2013: Saudi Journal of Anaesthesia
David Moszkowicz, Roberto Arienzo, Idir Khettab, Gabriel Rahmi, Franck Zinzindohoué, Anne Berger, Jean-Marc Chevallier
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is widely adopted but exposes serious complications. METHODS: A retrospective database analysis was done to study LSG staple line complications in a tertiary referral university center with surgical ICU experienced in treatment of morbid obesity and complications. Twenty-two consecutive patients were referred between January 2004 and February 2012 with postoperative gastric leak or stenosis after LSG. Interventions consisted in the control of intra-abdominal and general sepsis; restoration of staple line continuity or revision of LSG; nutritional support; treatment of associated complications...
May 2013: Obesity Surgery
Amir Abu Zikry, Kalindi Desousa, Khaled H Alanezi
Bariatric restrictive and malabsorptive operations are being carried out in most countries laparoscopically. Carbon dioxide or gas embolism has never been reported in obese patients undergoing bariatric surgery. We report a case of carbon dioxide embolism during laparoscopic sleeve gastrectomy (LSG) in a young super obese female patient. Early diagnosis and successful management of this complication are discussed. An 18-year-old super obese female patient with enlarged fatty liver underwent LSG under general anesthesia...
April 2011: Journal of Anaesthesiology, Clinical Pharmacology
Tomoki Nishiyama, Yumiko Kohno, Keiko Koishi
We undertook anesthesia of a 40-year-old woman with body weight of 228 kg and body mass index (BMI) of 90.6 kg/m(2) who was undergoing laparoscopic sleeve gastrectomy. This case may be the largest known patient undergoing general anesthesia in our country. Anesthesia was induced in a 30° head-up position with midazolam, fentanyl, droperidol, and inhalation of sevoflurane and nitrous oxide without muscle relaxants, and maintained with propofol, remifentanil, and pancuronium under pressure-controlled ventilation...
April 2011: Journal of Anesthesia
Karl-Hermann Fuchs, Wolfram Breithaupt, Thomas Schulz, Alexander Reinisch
BACKGROUND: Currently, advanced minimal-access surgery cannot be realized without the application of modern stapling devices. The introduction of stapling devices with a flexible shaft and computer-assisted steering abilities was followed by the technical basis to provide just these features. This study aimed to assess the clinical application of stapling devices connected to a flexible shaft supported by a computer-assisted drive for maneuvering the system and to study its feasibility, learning curve problems, and clinical safety criteria regarding morbidity of the patients...
June 2011: Surgical Endoscopy
Daniel B Wool, Harry J M Lemmens, Jay B Brodsky, Houman Solomon, Karen P Chong, John M Morton
BACKGROUND: Morbid obesity and bariatric surgery are both risk factors for the development of postoperative rhabdomyolysis (RML). RML results from injury to skeletal muscle, and a serum creatine phosphokinase (CK) level >1,000 IU/L is considered diagnostic of RML. The aim of this study was to determine if intraoperative intravenous fluid (IVF) volume affects postoperative CK levels following laparoscopic bariatric operations. STUDY DESIGN: Prospective, single blinded, and randomized trial was conducted...
June 2010: Obesity Surgery
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