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Revisional surgery

Kwang Hwan Park, Yeokgu Hwang, Seung Hwan Han, Yoo Jung Park, Dong Woo Shim, Woo Jin Choi, Jin Woo Lee
BACKGROUND: Recent studies have reported promising clinical results after osteochondral autograft transplantation (OAT) for the treatment of large osteochondral lesions of the talus (OLT). However, no study has yet compared clinical outcomes between primary and secondary OAT for large OLT. PURPOSE: The purpose is to compare clinical outcomes among patients with large OLT who receive primary OAT versus those who receive secondary OAT after failure of marrow stimulation and to identify factors associated with clinical failure...
March 1, 2018: American Journal of Sports Medicine
H Mason Hedberg, Alexander Trenk, Michael B Ujiki
BACKGROUND: Weight regain after Roux-en-Y gastric bypass affects up to 30% of individuals. A dilated gastrojejunostomy contributes to regain through decreased restriction. Endoscopic gastrojejunostomy revision is a safe alternative to revisional surgery. There is evidence that technique affects outcome, but the mechanical properties of various sutured repairs have not been evaluated. OBJECTIVE: To compare different suture patterns for endoscopic gastrojejunostomy revision using an ex vivo porcine model...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Gianfranco Donatelli, Ludovica Guerriero, Fabrizio Cereatti, Kostantinos Arapis, Carmelisa Dammaro, Jean-Loup Dumont, David Fuks, Silvana Perretta
INTRODUCTION: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula. MATERIAL AND METHODS: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula...
March 9, 2018: Obesity Surgery
Salman AlSabah, Eliana Al Haddad, Saud Al-Subaie, Shehab Ekrouf, Khaled Alenezi, Ahmad Almulla, Mohannad Alhaddad
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure as of 2015. However, inadequate weight loss may present the need for revisional procedures. OBJECTIVES: The objective of this study was to analyze the efficacy of single-anastomosis gastric bypass (SAGB) in attaining successful weight loss following an initial LSG. METHODS: A retrospective analysis was performed on all patients who underwent LSG at Amiri Hospital, Kuwait from 2008 to 2017...
March 8, 2018: Obesity Surgery
Alexandra Macmillan, Joseph Lopez, Gerhard S Mundinger, Melanie Major, Miguel A Medina, Amir H Dorafshar
BACKGROUND: Late treatment of scaphocephaly presents challenges including need for more complex surgery to achieve desired head shape. Virtual surgical planning for total vault reconstruction may mitigate some of these challenges, but has not been studied in this unique and complex clinical setting. METHODS: A retrospective chart review was conducted for patients with scaphocephaly who presented to our institution between 2000 and 2014. Patients presenting aged 12 months or older who underwent virtual surgical planning-assisted cranial vault reconstruction were included...
February 23, 2018: Journal of Craniofacial Surgery
Yun S Phua, Mark J Edmondson, Rachel J Kerr, Kirstie A Macgill, Rodrigo P Teixeira, Jonathan A Burge
OBJECTIVE: Autologous fat grafting of the velopharynx has been well described for the treatment of velopharyngeal insufficiency (VPI), with most studies purporting it as a technique with low morbidity useful in the treatment of mild VPI. Prompted by 3 cases of obstructive sleep apnea (OSA) following fat grafting of the velopharynx, we undertook a review of the outcomes of this procedure at our unit. DESIGN: Retrospective case series. PARTICIPANTS: All patients who underwent autologous fat grafting for VPI at the Royal Children's Hospital Melbourne...
March 2018: Cleft Palate-craniofacial Journal
Colette S Inaba, Christina Y Koh, Sarath Sujatha-Bhaskar, Lishi Zhang, Ninh T Nguyen
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been performed with successful discharge on postoperative day 1 (POD1). There are limited studies on same-day discharge after LRYGB. The objective of this study was to examine the frequency and outcomes of same-day discharge after LRYGB. STUDY DESIGN: The 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was analyzed for adult patients who underwent elective LRYGB cases with same-day versus POD1 discharge...
February 8, 2018: Journal of the American College of Surgeons
Katherine D Gray, Maureen D Moore, Adham Elmously, Omar Bellorin, Rasa Zarnegar, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: Utilization of the robotic platform has become more common in bariatric applications. We aim to show that robotic revisional bariatric surgery (RRBS) can be safely performed in a complex patient population with perioperative outcomes equivalent to laparoscopic revisional bariatric surgery (LRBS). METHODS: Retrospective review was conducted of adult patients undergoing laparoscopic revisional bariatric surgery (LRBS) or robotic revisional bariatric surgery (RRBS) at our institution from September 2007 to December 2016...
February 7, 2018: Obesity Surgery
Po-Ching Lee, Ray-Hon Chang, Yean-Lu Chang
Background: In Asian patients, nasal deviation secondary to augmentation rhinoplasty may result from underlying bony asymmetry that was not corrected intraoperatively. Diagnosis and treatment of this condition are complicated by the masking effect of dorsal implants. Objectives: The authors applied computed tomography (CT) to examine the causes of nasal deviation after augmentation rhinoplasty. CT results were utilized in preoperative planning for revisional surgery...
January 11, 2018: Aesthetic Surgery Journal
H Mason Hedberg, Alexander Trenk, Kristine Kuchta, John G Linn, JoAnn Carbray, Michael B Ujiki
BACKGROUND: Weight regain after bariatric roux-en-y gastric bypass affects up to 30% of individuals. Revisional surgery is risky, and is typically avoided in favor of dietary and psychological management. Endoscopic gastrojejunostomy revision is a low-morbidity, outpatient procedure that may be more effective than medical management alone for regain after gastric bypass. METHODS: Two patient cohorts were retrospectively assembled. Both groups had gastric bypass, regained weight, and were cleared for revision by their surgeon, dietician, and psychologist...
January 24, 2018: Surgical Endoscopy
Randolf A Widder, Thomas S Dietlein, Sven Dinslage, Pia Kühnrich, Corinna Rennings, Gernot Rössler
PURPOSE: The XEN45 Gel Stent is a flexible hydrophilic tube placed under the conjunctiva via the anterior chamber. This study investigates the IOP (intraocular pressure)-lowering potential, the risk profile, and the success rate of the XEN45 Gel Stent. METHODS: Two hundred and sixty-one eyes underwent surgery. The mean follow-up time was 8.5 months. The aim of the treatment was to achieve adequate IOP reduction without medication. Therefore, all patients who did not show sufficiently reduced IOP underwent a surgical revision with opening of the conjunctiva...
January 22, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
Thomas C C Boerlage, Gerardus P M Houben, Marcel J M Groenen, Klaas van der Linde, Arnold W J M van de Laar, Marloes Emous, Paul Fockens, Rogier P Voermans
BACKGROUND: Staple line leakage after bariatric surgery can be treated by endoscopic placement of a self-expandable stent. The success rate of stent placement is generally high, but migration is a frequent adverse event that hampers successful treatment. The Niti-S Beta stent is a fully covered double-bump stent that was specifically designed to prevent migration. This study aimed to evaluate the effectiveness and adverse event rate of the Niti-S Beta stent. METHODS: A retrospective study was performed in three high-volume bariatric centers...
January 17, 2018: Surgical Endoscopy
Alexandra Bucknor, Austin D Chen, Sabine Egeler, Patrick Bletsis, Anna Rose Johnson, Kate Myette, Samuel J Lin, Christine A Hamori
Background: The increasing demand for labiaplasty is well recognized; however, the procedure remains contentious. Objectives: We aim to provide a large-scale, up-to-date analysis of labiaplasty outcomes and factors influencing postoperative sequelae (POS). Methods: We analyzed a single-center, prospectively maintained database of females undergoing labiaplasty between 2002 and 2017. Demographic, procedural, and outcomes' data were retrieved...
January 9, 2018: Aesthetic Surgery Journal
Po-Ching Lee, Ray-Hon Chang, Yean-Lu Chang
Background: In Asian patients, nasal deviation secondary to augmentation rhinoplasty may result from underlying bony asymmetry that was not corrected intraoperatively. Diagnosis and treatment of this condition are complicated by the masking effect of dorsal implants. Objectives: The authors applied computed tomography (CT) to examine the causes of nasal deviation after augmentation rhinoplasty. CT results were utilized in preoperative planning for revisional surgery...
January 11, 2018: Aesthetic Surgery Journal
Antônio Moreira Mendes-Filho, Eduardo Sávio Nascimento Godoy, Helga Cristina Almeida Wahnon Alhinho, Manoel Dos Passos Galvão-Neto, Almino Cardoso Ramos, Álvaro Antônio Bandeira Ferraz, Josemberg Marins Campos
INTRODUCTION: Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux. OBJECTIVE: To evaluate the technical difficulty in performing gastric bypass in patients previously submitted to antireflux surgery, and its effectiveness in controlling gastroesophageal reflux...
October 2017: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Zachary M Helmen, Melissa C Helm, Joseph H Helm, Alexander Nielsen, Tammy Kindel, Rana Higgins, Jon C Gould
BACKGROUND: In bariatric surgery patients, urinary tract infections (UTIs) are one of the most common postoperative infections. In this study, we sought to determine if preoperative patient factors and perioperative processes contribute to an increased risk of UTI. METHODS: A retrospective analysis was performed of patients who underwent bariatric surgery at a single institution between March 2012 and May 2016. Standard protocol was antibiotic prophylaxis with cefazolin...
January 9, 2018: Obesity Surgery
Ying-Nan Tsai, Hsiu-Po Wang, Chih-Kun Huang, Po-Chin Chang, I-Chang Lin, Chi-Ming Tai
Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy...
January 2018: Kaohsiung Journal of Medical Sciences
Zubaidah Nor Hanipah, Elie C Nasr, Emre Bucak, Philip R Schauer, Ali Aminian, Stacy A Brethauer, Derrick Cetin
BACKGROUND: Some patients do not achieve optimal weight loss or regain weight after bariatric surgery. In this study, we aimed to determine the effectiveness of adjuvant weight loss medications after surgery for this group of patients. SETTING: An academic medical center. METHODS: Weight changes of patients who received weight loss medications after bariatric surgery from 2012 to 2015 at a single center were studied. RESULTS: Weight loss medications prescribed for 209 patients were phentermine (n = 156, 74...
January 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Laura E Sansosti, Jennifer C Van, Andrew J Meyr
Total ankle arthroplasty has become an increasingly used alternative to ankle arthrodesis for the treatment of end-stage ankle arthritis. However, despite progressive technological advances and the advent of multiple commercial implant systems, some concern remains for the relatively high complication and failure rates. The objective of the present investigation was to perform a systematic review of the incidence of complications in obese patients undergoing total ankle arthroplasty. We performed a review of electronic databases with the inclusion criteria of retrospective case series, retrospective clinical cohort analyses, and prospective clinical trials with ≥15 total participants, a mean follow-up period of ≥12 months, ≥1 defined cohort with a body mass index of ≥30 kg/m2, and a reported incidence rate of complications requiring revisional surgery at the final follow-up point...
December 25, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Stephanie Aelfers, Ignace M C Janssen, Edo O Aarts, Carolijn Smids, Marcel J Groenen, Frits J Berends
BACKGROUND: Inflammatory bowel diseases (IBD) are listed as a contraindication for bariatric surgery in various guidelines due to a theoretical higher complication risk. Therefore, little is known about safety and efficacy of bariatric surgery in IBD patients. AIM: We assessed the safety and efficacy of bariatric surgery and postoperative quality of life (QoL) in IBD patients. SETTING: The study was conducted in a large peripheral hospital in the Netherlands...
December 27, 2017: Obesity Surgery
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