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Revisional surgery

Lava Y Patel, Brittany Lapin, Craig S Brown, Thomas Stringer, Matthew E Gitelis, John G Linn, Woody E Denham, Elizabeth Farwell, Stephen Haggerty, Michael B Ujiki
BACKGROUND: Approximately 20-30 % of morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) will experience significant weight regain in the years following surgery. Endoscopic gastrojejunal revision (EGJR) has been shown to be a safe, effective and less invasive alternative to revisional surgery, with promising weight loss outcomes. However, minimal data exist regarding how to perform the procedure most effectively and what factors may predict good outcomes. We compared weight loss outcomes between patients undergoing endoscopic stoma revision by one of two full-thickness suturing techniques...
October 17, 2016: Surgical Endoscopy
Yusuke Watanabe, Amin Madani, Elif Bilgic, Katherine M McKendy, Gada Enani, Iman Ghaderi, Gerald M Fried, Liane S Feldman, Melina C Vassiliou
BACKGROUND: General surgery residency may not adequately prepare residents for independent practice. It is unclear; however, if non-ACGME-accredited fellowships are better meeting training needs. The purpose of this mixed-method study was to determine perceived preparedness for practice and to identify gaps in fellowship training. METHODS: A survey was developed using an iterative qualitative methodology based on interviews and focus groups of graduated fellows and program directors...
October 14, 2016: Surgical Endoscopy
William P Adams, Dean M Toriumi, Bruce W Van Natta
: Resolution of ptosis is a key step to the success of many plastic surgery procedures. Ptosis is a manifestation of tissue stretch. Tissue stretch can occur as a result of the natural aging process or health of the patient, or tissue may stretch under added weight or volume, such as when implants are placed. Surgical rejuvenation of ptotic tissues is very effective and results in marked changes in the patient profile yet the tissue that resulted in the need for the procedure first place has not improved and ptosis can recur...
October 3, 2016: Aesthetic Surgery Journal
Ricardo Zorron, Manoel Passos Galvão-Neto, Josemberg Campos, Alcides José Branco, José Sampaio, Tido Junghans, Claudia Bothe, Christian Benzing, Felix Krenzien
Background: Roux-en-Y gastric bypass (RYGB) is a standard therapy in bariatric surgery. Sleeve gastrectomy and gastric banding, although with good results in the literature, are showing higher rates of treatment failure to reduce obesity-associated morbidity and body weight. Other problems after bariatric may occur, as band erosion, gastroesophageal reflux disease and might be refractory to medication. Therefore, a laparoscopic conversion to a RYGB can be an effective alternative, as long as specific indications for revision are fulfilled...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
José Sampaio-Neto, Alcides José Branco-Filho, Luis Sérgio Nassif, André Thá Nassif, Flávia David João De Masi, Graciany Gasperin
Background: The gastric bypass has nutritional and electrolyte disturbances rate of approximately 17%. The most common deficits are protein malnutrition, ferric and zinc, in addition to the vitamin. Although rare, some malnutrition stages reach such severity that ends up being necessary hospitalization and sometimes revisional or reversal surgical procedures. Aim: To present a proposal of surgical revision for treatment of severe malnutrition after bariatric surgery...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Timothy C Boire, Daniel A Balikov, Yunki Lee, Christy M Guth, Joyce Cheung-Flynn, Hak-Joon Sung
Veins used as grafts in heart bypass or as access points in hemodialysis exhibit high failure rates, thereby causing significant morbidity and mortality for patients. Interventional or revisional surgeries required to correct these failures have been met with limited success and exorbitant costs, particularly for the US Centers for Medicare & Medicaid Services. Vein stenosis or occlusion leading to failure is primarily the result of neointimal hyperplasia. Systemic therapies have achieved little long-term success, indicating the need for more localized, sustained, biomaterial-based solutions...
September 27, 2016: Macromolecular Rapid Communications
Baptiste Brac, Lionel Rebibo, Jean-Philippe Lemouel, Jean-Marc Regimbeau
INTRODUCTION: Gastric band slippage with formation of a gastric pouch is a frequent complication after gastric banding. There is no consensus on the treatment of this condition, which differs within and between centers. Here, we describe our treatment of a large gastric pouch after gastric band slippage. Despite removal of the band, the pouch caused oral feeding intolerance. METHODS: The video shows our treatment of large gastric pouch following gastric banding and surgical revision...
September 20, 2016: Obesity Surgery
Örs Péter Horváth, Gábor Varga, Zsanett Biró, András Papp, Laura Bognár, András Vereczkei
Laparoscopic antireflux surgery is an effective treatment for patients with gastro-esophageal reflux disease, when it is refractory to conservative management. In experienced centers the procedure is safe, although complications may develop either during surgery or in the early or late postoperative period, which may necessitate revisional surgery. Between 1998 and 2015 a total of 407 patients underwent laparoscopic antireflux surgery at the Department of Surgery, University of Pécs. This interval was divided into two periods...
September 2016: Magyar Sebészet
Luciano Cardinale, Adriano Massimiliano Priola, Sandro Massimo Priola, Francesco Boccuzzi, Najada Dervishi, Elena Lisi, Andrea Veltri, Francesco Ardissone
In the post-operative course of the interventions of lung resection for primary tumor, complications of different nature and severity can arise, recognizing different pathogenetic mechanisms and differing according to the type of resection performed and to the time elapsed after surgery. The low diagnostic accuracy of chest radiography requires a thorough knowledge of the radiologist about all radiographic findings, both normal and pathological, which can be found in the immediate post-operative period (within 30 days after surgery)...
August 2016: Journal of Thoracic Disease
Maher El Chaar, Jill Stoltzfus, Leonardo Claros, Maureen Miletics
INTRODUCTION: Bariatric surgery is the only proven and effective long-term treatment for morbid obesity, with laparoscopic sleeve gastrectomy (LSG) being the most commonly performed weight loss procedure in the USA. Despite its safety and efficacy, LSG's association with both de novo and pre-existing gastroesophageal reflux disease (GERD) remains controversial. METHODS: Therefore, this retrospective study determined the incidence, indications, and outcomes of revisional surgery following LSG in adult patients at our institution from 2010 to 2014...
August 30, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
R Zorron, C Bothe, T Junghans, J Pratschke, C Benzing, F Krenzien
The Roux-en-Y gastric bypass (RYGB) is the therapy of choice in bariatric surgery. Sleeve gastrectomy and gastric banding are showing higher rates of treatment failure, reducing obesity-associated morbidity and body weight insufficiently. Moreover, gastroesophageal reflux disease (GERD) can occur refractory to medication. Therefore, a laparoscopic conversion to RYGB can be reasonable as long as specific conditions are fulfilled.Endoscopic procedures are currently being applied to revise bariatric procedures...
October 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Pablo Quadri, Raquel Gonzalez-Heredia, Mario Masrur, Lisa Sanchez-Johnsen, Enrique F Elli
BACKGROUND: Laparoscopic adjustable gastric banding (LAGB) was a popular procedure in the USA and Europe in the past decade. However, its use has currently declined. Band erosion (BE) is a rare complication after LAGB with a reported incidence rate of 1.46 %. Controversies exist regarding the management, approach and timing for the band removal. The aim of this study is to describe the rate, clinical presentation and perioperative outcomes of BEs at our institution and provide overall recommendations regarding the diagnosis and management of BE...
August 23, 2016: Surgical Endoscopy
Gautam Sharma, Jessica Ardila-Gatas, Mena Boules, Matthew Davis, James Villamere, John Rodriguez, Stacy A Brethauer, Jeffrey Ponsky, Matthew Kroh
BACKGROUND: Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). METHODS: A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB...
October 2016: Surgery
Nicolás Quezada, Julián Hernández, Gustavo Pérez, Mauricio Gabrielli, Alejandro Raddatz, Fernando Crovari
BACKGROUND: Sleeve gastrectomy (SG) is currently one of the most frequently performed bariatric interventions worldwide due to its simplicity and good weight loss results. Nevertheless, SG failure and complications are increasingly being observed as the number of procedures increases. OBJECTIVES: To report our results in converting SG to revisional laparoscopic Roux-en-Y gastric bypass (R-LRYGB). SETTING: University Hospital, Chile. METHODS: Retrospective analysis of our bariatric surgery database...
June 2, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Mark Fisher, Miguel Medina, Branko Bojovic, Edward Ahn, Amir H Dorafshar
The complex three-dimensional relationships in congenital craniofacial reconstruction uniquely lend themselves to the ability to accurately plan and model the result provided by computer-aided design and manufacturing (CAD/CAM). The goal of this study was to illustrate indications where CAD/CAM would be helpful in the treatment of congenital craniofacial anomalies reconstruction and to discuss the application of this technology and its outcomes. A retrospective review was performed of all congenital craniofacial cases performed by the senior author between 2010 and 2014...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Fabio Garofalo, Ronald Denis, Radu Pescarus, Henri Atlas, Simon L Bacon, Pierre Garneau
BACKGROUND: Bariatric surgery has been proven to be a safe and effective treatment for obesity with BMI (body mass index) reduction, and resolution or lowering of obesity-related co-morbidities. The relative age limit for bariatric surgery has gradually been increased to 60 years of age and above. OBJECTIVES: The aim of this study was to assess the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) performed in older patients (≥65 years old). SETTING: University hospital...
May 26, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Noah J Switzer, Shahzeer Karmali, Richdeep S Gill, Vadim Sherman
Revisional bariatric procedures are increasingly common. With more primary procedures being performed to manage severe obesity and its complications, 5% to 8% of these procedures will fail, requiring revisional operation. Reasons for revisional bariatric surgery are either primary inadequate weight loss, defined as less than 25% excess body weight loss, or weight recidivism, defined as a gain of more than 10 kg based on the nadir weight; however, each procedure also has inherit specific complications that can also be indications for revision...
August 2016: Surgical Clinics of North America
Adam C Celio, Kevin R Kasten, Matthew B Burruss, Walter J Pories, Konstantinos Spaniolas
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a commonly performed bariatric procedure. Readmissions are used as a quality indicator with a nationwide emphasis on reduction. In LRYGB surgery, surgeon volume studies have focused on correlation with technical outcomes, offering limited data on readmissions. Our aim was to evaluate nationwide data to explore the relationship between surgeon case volume and hospital readmissions following LRYGB. METHODS: The Bariatric Outcomes Longitudinal Database from 2011 was used for this study...
July 21, 2016: Surgical Endoscopy
Andrea Lazzati, Marie De Antonio, Luca Paolino, Francesco Martini, Daniel Azoulay, Antonio Iannelli, Sandrine Katsahian
OBJECTIVE: The aim of this study was to analyze the adjustable gastric banding (AGB) natural history on a national basis. BACKGROUND: Adjustable gastric banding represented the most common bariatric procedure in France until 2010. Since then, the number of AGBs has decreased and the rate of band removal and revisional surgeries has progressively increased. METHODS: For analysis, we included all adult patients operated on with AGB in France between 2007 and 2013...
July 18, 2016: Annals of Surgery
Antonio Iannelli, Tarek Debs, Francesco Martini, Benjamin Benichou, Imed Ben Amor, Jean Gugenheim
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has gained popularity as a standalone procedure. However, long-term complications are reported, mainly weight loss failure and gastroesophageal reflux disease (GERD). Therefore, demand for revisional surgery is rising. OBJECTIVES: The aim of this study was to report preliminary results within the 2 main indications for laparoscopic conversion of SG to Roux-en-Y gastric bypass (RYGB). SETTING: University Hospital, France...
April 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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