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endoscopic sleeve

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
Amador García Ruiz de Gordejuela, Almino Cardoso Ramos, Manoel Galvao Neto, Mario Nora, Antonio J Torres García, Andrés Sánchez Pernaute, Jordi Pujol Gebelli
INTRODUCTION: Live surgery is a topic of interest at every meeting or course in the field of surgery. The potential of laparoscopy for live broadcasting makes it an excellent tool in continuing medical education. Surgeons who participate in live surgeries are usually experienced, but several conditions may influence the results and safety of a procedure. OBJECTIVES: To analyze safety and outcomes in a series of patients who underwent surgery in the last 10 years in a live surgery course at our institution...
March 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Romano Schneider, Ioannis Lazaridis, Marko Kraljević, Christoph Beglinger, Bettina Wölnerhanssen, Ralph Peterli
BACKGROUND: Despite the increasing use of bariatric surgery as the most effective treatment of morbid obesity, there is still no consensus on its preoperative diagnostic workup. The aim of this study was to identify the pathologies of the endoscopic and radiologic investigations before performing bariatric surgery and to evaluate their impact on the patient management. METHODS: Retrospective analysis of prospectively collected data of 1225 consecutive patients who underwent laparoscopic Roux-en-Y gastric bypass (n = 834) or sleeve gastrectomy (n = 391) at our institution...
January 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Denisa Oprisanescu, Denisa Bucur, Vasile Sandru, Ioan Cristian Nedelcu, Madalina Ilie, Ruxandra Oprita, Gabriel Constantinescu
Non-malignant esophageal fistulas have a wide spectrum of clinical and pathological features and it`s important to learn to detect and treat them, due to significant morbidity, mortality and costs. The need for minimally invasive, efficient and also quick procedures is imperative. Esophageal stenting using fully-covered expandable stents has become an increasingly preferred option and addresses to fistulas which arise from 2-3 cm beyond Killian's mouth and up to the gastroesophageal junction. The long-term purpose of the procedure is closure of the fistula and thus healing...
January 2018: Chirurgia
Javier Graus Morales, Laura Crespo Pérez, Andrea Marques, Belén Marín Arribas, Rubén Bravo Arribas, Estefanía Ramo, Carmen Escalada, Carmen Arribas, Jacques Himpens
BACKGROUND: Endoscopic sleeve gastroplasty is a safe and feasible treatment for obesity. This study is focused on our technique modification which suggests a different suturing pattern in order to distribute suture tension more evenly. METHODS: A retrospective study of 148 patients (121 women) who underwent this procedure and were monitored for 12 months was conducted. The average age was 41.53 ± 10 years. The average BMI was 35.11 ± 5.5 kg/m2 with the average initial weight being 98...
February 28, 2018: Surgical Endoscopy
C Cosse, L Rebibo, F Brazier, S Hakim, R Delcenserie, J M Regimbeau
BACKGROUND: Gastric leak is the most feared surgical postoperative complication after sleeve gastrectomy. An endoscopic procedure is usually required to treat the leak. No data are available on the cost-effectiveness of different stent types in this procedure. METHODS: Between April 2005 and July 2016, patients with a confirmed gastric leak undergoing endoscopic treatment using a covered stent (CS) or double-pigtail stent (DPS) were included. The primary objective of the study was to assess overall costs of the stent types after primary sleeve gastrectomy...
February 22, 2018: British Journal of Surgery
Adrian Sartoretto, Zhixian Sui, Christine Hill, Margo Dunlap, Angielyn R Rivera, Mouen A Khashab, Anthony N Kalloo, Lea Fayad, Lawrence J Cheskin, George Marinos, Erik Wilson, Vivek Kumbhari
OBJECTIVE: Endoscopic sleeve gastroplasty (ESG), an incisionless endoscopic bariatric procedure, has shown impressive results in case series. This study examines the reproducibility, efficacy, and safety in three centers across two countries, and identifies key determinants for procedural success. DESIGN: Patients who underwent ESG between February 2016 and May 2017 at one of three centers (Australia and USA) were retrospectively analyzed. All procedures were performed on an outpatient basis using the Apollo OverStitch device (Apollo Endosurgery, Austin, TX)...
February 15, 2018: Obesity Surgery
Jiannis Anastasiou, Anas Hussameddin, Abdulaziz Al Quorain
Laparoscopic sleeve gastrectomy (LSG) is gaining popularity for the treatment of morbid obesity. It is regarded as a simple, low-cost procedure achieving significant weight loss within a short period of time. LSG is considered a safe procedure with a relatively low complication rate. The complications encountered nevertheless can result in significant morbidity and may even be lethal. The most significant complications are staple-line bleeding, stricture, and staple-line leak. The purpose of this paper is to present a case of a 31-year-old patient complicated by a 3...
September 2017: Case Reports in Gastroenterology
D O Nicholas Sousa, D O Rahil Dharia, D O Shilpin Mehta, D O Keith Marshall, D O David Siegel
Leak following laparoscopic sleeve gastrectomy is one of the most feared complications and its management can be difficult and frustrating for patients and physicians involved. Using multimodality approach and having variable options to plan management for patients presenting with leak following bariatric surgery can be advantageous for physicians. The use of endoscopic injection of EpiFix-dehydrated Human Amnion/Chorion Membrane (dHACM) allograft can be a novel adjunct in facilitating healing of the leak site by iatrogenic introduction of tissue growth factors, cytokines and building connective tissue matrix...
September 2017: Journal of Surgical Case Reports
Sara E Martin Del Campo, Dean J Mikami, Bradley J Needleman, Sabrena F Noria
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has risen in prevalence as a standalone surgical option for treating obesity over the last 15 years. One of the most worrisome complications is development of a leak at the gastrectomy staple line. OBJECTIVE: The objective of this report is to describe our single-institution experience in managing SG staple-line leaks with fully covered endoscopic stents. SETTING: Academic medical center, United States...
December 19, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Sheng-Hua Tsai, Hsuan-Han Wu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: Endoscopic surgery has been successfully applied in the treatment of degenerative spinal disease, but few studies have assessed its use in treating sacral metastasis. Herein, a successful full endoscopic interlaminar approach for sacral nerve root decompression of a sacral metastatic tumor was presented. CASE DESCRIPTION: An 80-year-old man with history of hepatocellular carcinoma suffered from buttock pain with radiation to the right lower leg for one week...
January 17, 2018: World Neurosurgery
Adel Alhaj Saleh, Michal R Janik, Rami R Mustafa, Mohammed Alshehri, Adil H Khan, Seyed Mohammad Kalantar Motamedi, Shiraz Rahim, Indravadan Patel, Amir Aryaie, Mujjahid Abbas, Tomasz Rogula, Leena Khaitan
INTRODUCTION: Sleeve gastrectomy (SG) is one of the most common procedures performed for weight loss. Many seek the "perfect sleeve" with the notion that the type of calibrating device affects sleeve shape, and this in turn will affect outcomes and complications. Two major concerns after SG are amount of weight loss and acid reflux. Our aim was to determine if the various calibration methods could impact sleeve shape and thereby allow for better outcomes of weight loss and reflux. METHODS: A retrospective chart review was performed of 210 patients who underwent SG and had postoperative upper gastrointestinal (UGI) study from 2011 to 2015 in a single center by a single (fellowship-trained) bariatric surgeon...
January 8, 2018: Obesity Surgery
Maria S Altieri, Brian Wright, Andrew Peredo, Aurora D Pryor
BACKGROUND: As the number of obese patients in the United States continues to grow, there is a parallel increase in the number of bariatric surgery patients. A quarter of these patients will return to the Emergency Department (ED) within the first two years of the index procedure. OBJECTIVE: An understanding of the most common bariatric procedures and their related complications will greatly aide the Emergency Medicine physician in the care of these patients. DISCUSSION: Abdominal pain is the most common reason for bariatric patients to present to the ED and can represent a diagnostic challenge to EM physicians...
December 2, 2017: American Journal of Emergency Medicine
Samuel Torres-Landa, Umashankkar Kannan, Isabella Guajardo, Octavia E Pickett-Blakely, Daniel T Dempsey, Noel N Williams, Kristoffel R Dumon
Obesity is a spreading epidemic associated with significant morbidity and mortality with a prevalence of over 36% worldwide. In the face of a growing epidemic, increasing medical costs, and the disappointing limitations of medical and lifestyle modification bariatric surgery was found to consistently lead to significant weight loss and improvement in obesity-associated comorbidities when compared to non-surgical interventions. Bariatric procedures fall within three basic categories: restrictive procedures, malabsorptive procedures, and procedures that combine both restrictive and malabsorptive mechanisms...
February 2018: Minerva Chirurgica
Camila B Ortega, Alfredo D Guerron, Dana Portenier
BACKGROUND: Postoperative leaks develop in a low percentage of patients undergoing laparoscopic sleeve gastrectomy (LSG), representing a rare yet devastating postoperative complication increasing morbidity and hospital stay. Leaks can become collections and may be very difficult to manage. Several therapeutic options with variable results, including surgical and nonsurgical methods have been described. Endoscopic abscess septotomy is an alternative method recently performed by a few centers reporting efficacy and safety outcomes...
December 13, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Germán Viscido, Verónica Gorodner, Franco Signorini, Luciano Navarro, Lucio Obeide, Federico Moser
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has shown excellent results in terms of weight loss and resolution of comorbidities. Despite that, the effect of LSG on gastroesophageal reflux disease (GERD) is still a controversial topic. Our objective was to evaluate the presence of gastroesophageal reflux symptoms, erosive esophagitis (EE), and hiatal hernia (HH) in obese patients undergoing LSG. METHODS: Prospective observational study. LSG patients were studied before and at 18-month follow-up...
January 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Jennifer L Levy, Marc S Levine, Stephen E Rubesin, Noel N Williams, Kristoffel R Dumon
OBJECTIVE: To determine the clinical, radiographic, and endoscopic findings of sleeve stenosis after sleeve gastrectomy and to correlate treatment with outcomes. METHODS: We identified 43 patients who underwent barium studies to evaluate upper GI symptoms after laparoscopic sleeve gastrectomy. The clinical, radiographic, and endoscopic findings were reviewed and correlated with treatment and outcomes. RESULTS: 26 patients (60%) had sleeve stenoses...
February 6, 2018: British Journal of Radiology
P Praveen Raj, Siddhartha Bhattacharya, S Saravana Kumar, R Parthasarathi, C Palanivelu
Bariatric surgery can be safely combined with laparoscopic intraperitoneal onlay mesh (IPOM) repair. In case of large ventral hernias, laparoendoscopic component separation can also be combined to achieve tension-free closure of the defect. Concomitant bariatric surgery and hernia repair also offer the additional benefit of reduction in recurrence of hernias as obesity, one of the risk factors, is treated in the process. We present a case of 60-year-old man with a body mass index of 45.3 kg/m2 with a large recurrent ventral hernia...
December 11, 2017: Journal of Minimal Access Surgery
G Currò, G Piscitelli, C Lazzara, I Komaei, A Fortugno, G Pinto, F Guccione, A Cogliandolo, A Dattola, S Latteri, G Navarra
BACKGROUND AND AIMS: Bleeding and staple line leak are the most common postoperative complications of LSG. To prevent and/or to promptly identify such complications, conventional peri-operative protocols imply post-operative gastric decompression (NGT) and staple line drain (IAD). Our aim was to evaluate the role of naso-gastric tube (NGT) and intra-abdominal drain (IAD) in preventing and/or facilitating identification and treatment of post-operative complications after sleeve gastrectomy...
July 2017: Il Giornale di Chirurgia
Erkan Yardimci, Suleyman Bozkurt, Lutfullah Baskoy, Huseyin Kazim Bektasoglu, Melin Ozgun Gecer, Samet Yigman, Huseyin Akbulut, Halil Coskun
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most preferred technique in morbidly obese patients for weight loss. There is a controversy about the routine preoperative evaluation of the stomach and the routine microscopic examination of all LSG specimens. Our aim is to analyze the results of both preoperative upper gastrointestinal endoscopy and endoscopic biopsies and also the results of histopathological examination of LSG specimens. MATERIALS AND METHODS: The data of patients who underwent LSG from January 2011 to November 2016 were analyzed retrospectively from a prospectively collected database...
November 18, 2017: Obesity Surgery
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