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Endoscopic bariatric

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https://www.readbyqxmd.com/read/28811552/deregulation-of-transcription-factors-controlling-intestinal-epithelial-cell-differentiation-a-predisposing-factor-for-reduced-enteroendocrine-cell-number-in-morbidly-obese-individuals
#1
Bettina K Wölnerhanssen, Andrew W Moran, Galina Burdyga, Anne Christin Meyer-Gerspach, Ralph Peterli, Michael Manz, Miriam Thumshirn, Kristian Daly, Christoph Beglinger, Soraya P Shirazi-Beechey
Morbidly obese patients exhibit impaired secretion of gut hormones that may contribute to the development of obesity. After bariatric surgery there is a dramatic increase in gut hormone release. In this study, gastric and duodenal tissues were endoscopically collected from lean, and morbidly obese subjects before and 3 months after laparoscopic sleeve gastrectomy (LSG). Tissue morphology, abundance of chromogranin A, gut hormones, α-defensin, mucin 2, Na(+)/glucose co-transporter 1 (SGLT1) and transcription factors, Hes1, HATH1, NeuroD1, and Ngn3, were determined...
August 15, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28809386/complications-of-bariatric-surgery-what-you-can-expect-to-see-in-your-gi-practice
#2
REVIEW
Allison R Schulman, Christopher C Thompson
Obesity is one of the most significant health problems worldwide. Bariatric surgery has become one of the fastest growing operative procedures and has gained acceptance as the leading option for weight-loss. Despite improvement in the performance of bariatric surgical procedures, complications are not uncommon. There are a number of unique complications that arise in this patient population and require specific knowledge for proper management. Furthermore, conditions unrelated to the altered anatomy typically require a different management strategy...
August 15, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28750839/endoscopic-treatment-of-fistulas-after-sleeve-gastrectomy-a-comparison-of-internal-drainage-versus-closure
#3
Diane Lorenzo, Théophile Guilbaud, Jean Michel Gonzalez, Alban Benezech, Anne Dutour, Sandrine Boullu, Stéphane Berdah, Thierry Bège, Marc Barthet
BACKGROUND AND AIMS: Post-sleeve gastrectomy fistulas (PSGF) are major adverse events of bariatric surgery. The endoscopic management strategy evolved from closure to internal drainage (ID) after 2013. The main objective was to evaluate and compare these different approaches. METHODS: This retrospective study included all patients treated for PSGF in a referral center. "Closure" management was defined as initial treatment using covered-metal-stent and/or endoclips...
July 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28740414/the-role-of-endoscopic-therapy-in-obesity-management-intragastric-balloons-and-aspiration-therapy
#4
REVIEW
Nitin Kumar, Shelby Sullivan, Christopher C Thompson
Weight management is increasingly incorporating endoscopic bariatric therapy (EBT). As the global burden of obesity and its comorbidities has increased, it is evident that novel therapeutic approaches will be necessary to address the obesity epidemic. EBTs offer greater efficacy than diet and lifestyle modification and lower invasiveness than bariatric surgery. The US Food and Drug Administration has approved two intragastric balloons and aspiration therapy for the treatment of obesity: Apollo Orbera is indicated for the treatment of Class I and Class II obesity, Re Shape Integrated Dual Balloon system is indicated for the same range with a comorbidity, and Aspire Bariatrics AspireAssist is approved for patients with a body mass index of 35-55 kg/m(2)...
2017: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#5
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#6
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28716404/partial-jejunal-diversion-using-an-incisionless-magnetic-anastomosis-system-1-year-interim-results-in-subjects-with-obesity-and-diabetes
#7
Evžen Machytka, Marek Bužga, Pavel Zonca, David B Lautz, Marvin Ryou, Donald C Simonson, Christopher C Thompson
BACKGROUND AND AIMS: The majority of patients with type 2 diabetes mellitus (T2DM) have obesity. Studies show that bariatric surgery is superior to medical treatment for remission of T2DM. Nevertheless, very few patients undergo surgery, and a less-invasive endoscopic alternative is desirable. METHODS: This was a single-arm first-in-human pilot study, designed to evaluate the technical feasibility, safety, and clinical performance of the incisionless magnetic anastomosis system (IMAS) in creation of a partial jejunal diversion (PJD)...
July 14, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28707286/intragastric-balloon-treatment-for-obesity-review-of-recent-studies
#8
REVIEW
Chinara M Tate, Allan Geliebter
INTRODUCTION: The FDA recently approved three intragastric balloon (IGB) devices, ReShape, ORBERA™, and Obalon for treatment of obesity. Given the high cost, complication risk, and invasiveness of bariatric surgery, IGB treatment may present a safer and lower cost option for weight reduction. IGBs are generally placed in the stomach endoscopically for up to 6 months to reduce gastric capacity, enhance feelings of fullness, and induce weight loss. The mechanism of action likely involves stimulation of gastric mechanoreceptors triggering short-acting vagal signals to brain regions implicated in satiety...
July 13, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#9
Hany Shehab, Emad Abdallah, Khaled Gawdat, Inas Elattar
BACKGROUND: Endoscopic stents are successful in the management of surgical leaks; however, stent migration remains a significant problem. In this study, we present our approach depending on a large bariatrics-specific stent (Mega stent) and over-the-scope clips in the management of post-bariatric surgery leaks. METHODS: A retrospective analysis of all patients with post-bariatric surgery leaks treated at our institution using an approach reliant on Mega stents and over-the-scope clips was conducted...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28698663/medical-devices-for-the-treatment-of-obesity
#10
REVIEW
Phong Ching Lee, John Dixon
Obesity is a major public health concern that leads to numerous metabolic, mechanical and psychological complications. Although lifestyle interventions are the cornerstone of obesity management, subsequent physiological neurohormonal adaptations limit weight loss, strongly favour weight regain and counteract sustained weight loss. A range of effective therapies are therefore needed to manage this chronic relapsing disease. Bariatric surgery delivers substantial, durable weight loss but limited access to care, perceived high risks and costs restrict uptake...
July 12, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28695459/endoscopic-vacuum-therapy-evt-a-new-concept-for-complication-management-in-bariatric-surgery
#11
Fabian Schmidt, Rudolf Mennigen, Thorsten Vowinkel, Philipp A Neumann, Norbert Senninger, Daniel Palmes, Mike G Laukoetter
BACKGROUND: Bariatric surgery is the most efficient therapy for morbid obesity. Staple line and anastomotic leakage are the most feared postoperative complications after Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy (LSG). Traditional treatment options like revisional surgery and endoscopic stent placement are associated with high morbidity and mortality as well as variable success rates. Endoscopic vacuum therapy (EVT) has shown to be a new successful and feasible treatment option for leaks of different etiology after major gastro-esophageal surgery...
July 10, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28689322/linear-stapled-gastrojejunostomy-results-in-fewer-strictures-compared-to-circular-stapled-gastrojejunostomy-in-laparoscopic-gastric-bypass-surgery
#12
Larissa Vines, Thomas Frick, Stefan Aczél, Dagmar L'Allemand, Jan Borovicka, Marc Schiesser
PURPOSE: Currently, there are two laparoscopic stapling techniques to perform the gastrojejunostomy in gastric bypass surgery: the linear stapling and circular stapling techniques. The aim of the study was to compare the two techniques regarding postoperative morbidity and weight loss at an accredited bariatric reference center in Switzerland. METHODS: We compared two consecutive cohorts at a single institution between November 2012 and June 2014 undergoing laparoscopic gastric bypass surgery...
July 8, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28682794/bariatric-endoscopy-state-of-the-art
#13
Vivek Kumbhari, Christine Hill, Shelby Sullivan
PURPOSE OF REVIEW: This review aims to present the current state of the field, highlight recent developments, and describe the clinical outcomes of these endoscopic bariatric and metabolic procedures. RECENT FINDINGS: There are an increasing number of devices and techniques that are available for the endoluminal treatment of obesity. It is now possible to offer FDA approved endoscopic therapies for patients with BMI as high as 55 kg/m. Although tremendous advances have been made, there is room for additional emphasis with regards to the metabolic improvements seen with these therapies, in addition to highlighting weight loss outcomes...
September 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28668407/current-and-cutting-edge-interventions-for-the-treatment-of-obese-patients
#14
REVIEW
Jenanan Vairavamurthy, Lawrence J Cheskin, Dara L Kraitchman, Aravind Arepally, Clifford R Weiss
The number of people classified as obese, defined by the World Health Organization as having a body mass index ≥30, has been rising since the 1980s. Obesity is associated with comorbidities such as hypertension, diabetes mellitus, and nonalcoholic fatty liver disease. The current treatment paradigm emphasizes lifestyle modifications, including diet and exercise; however this approach produces only modest weight loss for many patients. When lifestyle modifications fail, the current "gold standard" therapy for obesity is bariatric surgery, including Roux-en-Y gastric bypass, sleeve gastrectomy, duodenal switch, and placement of an adjustable gastric band...
August 2017: European Journal of Radiology
https://www.readbyqxmd.com/read/28664438/transoral-outlet-reduction-with-full-thickness-endoscopic-suturing-for-weight-regain-after-gastric-bypass-a-large-multicenter-international-experience-and-meta-analysis
#15
Eric J Vargas, Fateh Bazerbachi, Monika Rizk, Tarun Rustagi, Andres Acosta, Erik B Wilson, Todd Wilson, Manoel Galvao Neto, Natan Zundel, Manpreet S Mundi, Maria L Collazo-Clavell, Shah Meera, H S Abu-Lebdeh, Paul A Lorentz, Karen B Grothe, Matthew M Clark, Todd A Kellogg, Travis J McKenzie, Michael L Kendrick, Mark D Topazian, Christopher J Gostout, Barham K Abu Dayyeh
BACKGROUND AND AIMS: Many patients who undergo bariatric surgery will experience weight regain and effective strategies are needed to help these patients. A dilated gastrojejunal anastomosis (GJA) has been associated with weight recidivism after Roux-en-Y gastric bypass surgery (RYGB). Endoscopic transoral outlet reduction (TORe) with a full thickness endoscopic suturing device (Overstitch, Apollo Endosurgery, Austin, TX) is a minimally invasive therapeutic option. The primary aim of this project was to examine the safety and long-term efficacy data from three bariatric surgery centers and to conduct a systematic review and meta-analysis of the existing literature...
June 29, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28655987/fully-dual-knife-j-%C3%A2-submucosal-tunnel-endoscopic-resection-ster-a-step-up-to-bariatric-surgery
#16
Gianfranco Donatelli, Panagiotis Lainas, Ibrahim Dagher
No abstract text is available yet for this article.
2017: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/28641031/treatment-options-for-nonalcoholic-steatohepatitis-a-safety-evaluation
#17
REVIEW
Danny Issa, Julia Wattacheril, Arun J Sanyal
There is an urgent as yet unmet need to develop highly effective and safe therapeutics for nonalcoholic fatty liver disease (NAFLD). The remarkable progress in understanding NAFLD pathogenesis allowed the identification of injury pathways which may be recruited as therapy targets. Areas covered: This article reviews the safety and tolerability data of the NAFLD therapies and explains the mechanistic basis for each of the established and investigational drugs. Treatment targets include: weight loss, anti-metabolic agents such as lipid lowering and anti-diabetic drugs, inflammation, fibrosis and others such as targeting gut microbiota, immune modulation and apoptosis...
August 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28639045/passing-the-fundamentals-of-endoscopic-surgery-fes-exam-linking-specialty-choice-and-attitudes-about-endoscopic-surgery-to-success
#18
Aimee K Gardner, Michael B Ujiki, Brian J Dunkin
INTRODUCTION: Previous work has shown that up to 30% of graduating surgery residents fail the fundamentals of endoscopic surgery (FES) exam. This study investigated the extent to which FES pass rates differ in a specific sample of individuals who have chosen a career in GI surgery and to examine the relationships between FES performance and confidence in performing flexible endoscopy. METHODS: Fellows attending the 2016 SAGES Flexible Endoscopy Course were invited to complete the FES manual skills examination...
June 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28622478/novel-nonsurgical-endoscopic-approaches-for-the-treatment-of-obesity
#19
Ryan T Hurt, Thomas H Frazier, Manpreet S Mundi
Globally, obesity is a leading cause of preventable death and is associated with >60 comorbid medical conditions, including 10 types of cancer that are strongly associated with body mass index. There are a number of traditional obesity treatments-for example, lifestyle management (eg, decreased caloric intake and increased expenditure), pharmacotherapy, and bariatric surgery. Recently, endoscopic approaches have emerged as a viable alternative for weight loss. Endoscopically placed intragastric balloons were introduced in the early 1980s for the treatment of medically complicated obesity but, unfortunately, had high rates of complications, such as premature deflation leading to obstruction...
June 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28613044/for-debate-should-bariatric-surgery-be-performed-in-children-and-adolescents-with-hypothalamic-obesity
#20
EDITORIAL
Sarka Stolbova, Marek Benes, Lenka Petruzelkova, Jan Lebl, Stanislava Kolouskova
Hypothalamic dysfunction leading to severe obesity is a serious long-term consequence of paediatric craniopharyngioma. It compromises quality of life, leads to long-term metabolic hazards, and may shorten life expectancy. Therefore, a proactive approach is required. Conventional treatment of hypothalamic obesity is difficult and hardly successful. Experience with bariatric surgery is limited, especially in younger patients. Two retrospective studies recently reported on classic bariatric surgery in a small series of individuals after craniopharyngioma...
June 2017: Pediatric Endocrinology Reviews: PER
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