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Laparoscopic roux en y gastric bypass

Anna M Schürner, Giulia Manzini, Marco Bueter, Erik Schadde, Beatrice Beck-Schimmer, Martin Schläpfer
BACKGROUND: Conservative obesity treatment often leads to limited results. Bariatric surgery is highly efficient, but the candidates are at risk of developing perioperative complications. Bariatric outcomes have been well described in the past, but there are only few reports of perioperative outcomes. The aim of this study was to evaluate the incidence of anaesthetic and surgical complications of Roux-en-Y bypass. METHODS: Data of all adult patients, who underwent primary Roux-en-Y gastric bypass surgery between 1/2006 and 12/2013 at the University Hospital Zurich were analysed...
December 13, 2018: BMC Anesthesiology
Lindsay Wakayama, Katherine Nameth, Sarah Adler, Debra L Safer
BACKGROUND: Sarwer et al. found that poor dietary adherence at 6 months postoperatively predicted lower weight loss. OBJECTIVES: To replicate and extend these findings. SETTING: University bariatric clinic. METHODS: Fifty-four adults (72% female; age 51.1 ± 11.3 yr; mean body mass index [BMI] = 43.8 ± 7.4 kg/m2 ; 53.7% = Roux-en-Y gastric bypass, 42.6% = laparoscopic sleeve gastrectomy, and 3.7% = gastric banding) were identified as low or high dietary adherers following the method of Sarwer et al...
November 6, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Frédéric Borel, Julien Branche, Grégory Baud, Romain Gérard, François Pattou, Robert Caiazzo
BACKGROUND: The incidence of biliary lithiasis is increased after bariatric surgery due to rapid weight loss [1]. Trans-oral endoscopic management in cases of common bile duct gallstone complication is not possible in patients with Roux-en-Y gastric bypass (RYGB) due to the modified anatomy. Access to the biliary tree after RYGB with a classical direct surgical approach of common bile duct and choledocoscopy can be used, but may be complicated in situations of acute cholangitis because of the fragility of common duct, or in cases of previous cholecystectomy...
December 11, 2018: Obesity Surgery
Myrian Vinan-Vega, Tamara Diaz Vico, Enrique F Elli
BACKGROUND: Indications and outcomes of bariatric surgery in the elderly remain controversial. We aimed to evaluate and compare safety and early outcomes of bariatric procedures in this age group. STUDY DESIGN: We performed a retrospective case-control study of Mayo Clinic bariatric surgery patients from January 1, 2016, to January 31, 2018. Data collection included surgery type, sex, age, body mass index (BMI), and comorbidities (hypertension, diabetes mellitus, hyperlipidemia, and obstructive sleep apnea (OSA))...
December 7, 2018: Obesity Surgery
Salvatore Docimo, Uzma Rahmana, Andrew Bates, Mark Talamini, Aurora Pryor, Konstantinos Spaniolas
Obesity is associated with the development of gastroesophageal reflux disease (GERD) and hiatal hernia (HH). This study aimed to assess practice patterns regarding concomitant HH repair (HHR) during laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The incidence of concomitant HHR with LSG or LRYGB was analyzed using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. One hundred thirty thousand, seven hundred seventy-two patients underwent RYGB (30...
December 7, 2018: Obesity Surgery
Andrada-Loredana Popescu, Florentina Ioniţa-Radu, Mariana Jinga, Andrei-Ionuţ Gavrilă, Florin-Alexandru Săvulescu, Carmen Fierbinţeanu-Braticevici
The prevalence of obesity is rising, becoming a medical problem worldwide. Also GERD incidence is higher in obese patients compared with normal weight, with an increased risk of 2.5 of developing symptoms and erosive esophagitis. Different treatment modalities have been proposed to treat obese patients, but bariatric surgery due to its complex interactions via anatomic, physiologic and neurohormonal changes achieved the best long-term results, with sustained weight loss and decrease of complications and mortality caused by obesity...
December 1, 2018: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Ivy N Haskins, Lisbi Rivas, Tammy Ju, Ashlyn E Whitlock, Richard L Amdur, Anton N Sidawy, Paul P Lin, Khashayar Vaziri
BACKGROUND: Venous thromboembolism, including pulmonary embolism (PE) and deep venous thrombosis, is a leading cause of morbidity and mortality after bariatric surgery. Inferior vena cava filters (IVCFs) have been used as a method to reduce the incidence of clinically significant PEs after bariatric surgery. OBJECTIVES: To compare the incidence of postoperative PEs in patients with IVCFs with those in patients without IVCFs at the time of bariatric surgery. SETTING: American College of Surgeons Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program...
October 18, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Syed Nabeel Zafar, Nicole Shockcor, Nikhil Prasad, Eric S Wise, Hope T Jackson, Mark Kligman
Measures to reduce postoperative bleeding (POB) after bariatric surgery is skewed toward laparoscopic sleeve gastrectomy (LSG). We use 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) to characterize the differences in bleeding rates between LSG and laparoscopic Roux-en-Y gastric bypasses (LRYGB). Propensity score matching and multivariable logistic regressions tested for independent differences in POB rates. A total of 168,093 patients from 742 centers were identified in the data set...
November 28, 2018: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Brooks V Udelsman, David C Chang, Ralitza Parina, Mark A Talamini, Keith D Lillemoe, Elan R Witkowski
OBJECTIVE: The objective of this study was to determine the effects of open versus laparoscopic surgery on the development of adhesive small bowel obstruction (aSBO). SUMMARY BACKGROUND DATA: aSBO is a significant contributor to short and long-term postoperative morbidity. Laparoscopy has demonstrated a protective effect in colorectal surgery, but these effects have not been generalized to other abdominal procedures. METHODS: Population level California state data (1995-2010) was analyzed...
November 29, 2018: Annals of Surgery
Pia Henfridsson, Anna Laurenius, Ola Wallengren, Eva Gronowitz, Jovanna Dahlgren, Carl-Erik Flodmark, Claude Marcus, Torsten Olbers, Lars Ellegård
BACKGROUND: Information is scarce on long-term changes in energy intake (EI), dietary energy density (DED), and body composition in adolescents undergoing laparoscopic Roux-en-Y gastric bypass (RYGB). OBJECTIVES: To investigate long-term changes in EI, DED, and body composition in adolescents after LRYGB. SETTING: University hospitals, multicenter study, Sweden. METHODS: Eighty-five adolescents (67% girls; mean ± standard deviation, age 16...
October 18, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
A Schäfer, Philipp Gehwolf, J Umlauft, T Dziodzio, M Biebl, A Perathoner, F Cakar-Beck, H Wykypiel
BACKGROUND: Revisional laparoscopic Roux-en-Y gastric bypass (R-LRYGB) is the preferred procedure after failed adjustable gastric banding. Little is known about whether a one-stage procedure (one surgery for band removal and R-LRYGB) or a two-stage procedure (first band removal and later R-LRYGB) is superior. Aim of this study is to compare early- and long-term results of both methods at our institution. METHODS: Retrospective analysis of 165 (m 26/f 139) consecutive patients (98 one-stage, 67 two-stage) with R-LRYGB...
November 27, 2018: Obesity Surgery
Saurav Chakravartty, Gillian Vivian, Nicola Mullholland, Hizbullah Shaikh, John McGrath, Paul S Sidhu, Ounali Jaffer, Ameet G Patel
BACKGROUND: In bariatric surgery, preoperative very low-calorie diets (VLCD) may better meet the technical demands of surgery by shrinking the liver. However, diets may affect tissue healing and influence bowel anastomosis in an as-yet-undefined manner. OBJECTIVE: This randomized controlled trial aimed to examine the effect on collagen deposition in wounds in patients on a 4-week VLCD before laparoscopic gastric bypass. SETTING: University hospital...
October 12, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Abel Boerboom, Jens Homan, Edo Aarts, Theo Aufenacker, Ignace Janssen, Frits Berends
BACKGROUND: For a number of years the laparoscopic adjustable gastric band has been one of the leading bariatric procedures with good short-term outcomes. However, inadequate weight loss, weight regain, and other band-related complications in the long term led to an increase in revisional Roux-en-Y gastric bypass (RYGB) procedures. Lengthening the biliopancreatic limb, a relatively simple and safe adjustment of the standard technique, could improve the results of the revisional procedure...
October 18, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Peter W Lundberg, Abigail Gotsch, Eonjung Kim, Leonardo Claros, Jill Stotlzfus, Maher El Chaar
The laparoscopic adjustable gastric band (AGB) has fallen out of favor due to poor long-term weight loss and frequent complications. Many patients stand to benefit from elective conversion of AGB to more durable procedures such as sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB). Whether it is safer to perform this conversion in one or two stages, however, remains controversial. We performed an IRB-approved review of prospectively collected data from all one-stage band conversions performed at our institution from January 2012 to December 2017...
November 22, 2018: Updates in Surgery
Antoine Vallois, Benjamin Menahem, Yannick Le Roux, Adrien Lee Bion, Hugo Meunier, Thomas Gautier, Nicolas Contival, Andrea Mulliri, Jean Lubrano, Jean-Jacques Parienti, A Alves
OBJECTIVE: To evaluate the safety and efficacy of revisional Roux-en-Y gastric bypass (RYGB) after adjustable gastric banding (AGB) or sleeve gastrectomy (SG) compared with primary RYGB, in regard to early and late morbidity, weight, and resolution of obesity-related comorbidities. METHODS: The group of patients undergoing revisional RYGB was matched in a 1:1 ratio with control patient who underwent a primary RYGB, based on age, gender, American Society of Anesthesiologist (ASA) score, preoperative body mass index (BMI), and diabetes mellitus...
November 22, 2018: Obesity Surgery
Ahmad Ghazal, Mourad Niazi, Israa Kannas, Asmaa Alhasan, Hanadi Hawa
BACKGROUND: While LAGB has become uncommon in the bariatric surgery practice, band removal with or without revision surgery is still common. Retained postoperative foreign body, of which surgical sponges are the most common, is a rare condition. We report a rare case of retained gastric band port and the attached tube. CASE PRESENTATION: A 31-year-old Caucasian female presented to the outpatient clinic, 5 years after her last surgery, complaining of a left upper quadrant abdominal mass over the last 2 years...
November 22, 2018: BMC Surgery
Olof Backman, Jacob Freedman, Richard Marsk, Henrik Nilsson
BACKGROUND: Anastomotic complications after laparoscopic Roux-en-Y gastric bypass (LRYGB) including leaks, ulceration, and stenosis remain a significant cause of post-operative morbidity and mortality. Our objective was to compare two different surgical techniques regarding short-term anastomotic complications. METHODS: A retrospective analysis of all patients operated with a primary LRYGB from 2006 to June 2015 in one institution, where prospectively collected data from an internal quality registry and medical journals were analyzed...
November 20, 2018: Surgical Endoscopy
Konstantinos Arapis, Nicoletta Macrina, Diana Kadouch, Lara Ribeiro Parenti, Jean Pierrre Marmuse, Boris Hansel
BACKGROUND: Among the population of morbidly obese people, super-super-obese (SSO) individuals (body mass index >60 kg/m2 ) present a treatment challenge for bariatric surgeons. OBJECTIVES: To compare the long-term outcomes between laparoscopic sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (RYGB) and to evaluate the efficacy of SG as a stand-alone bariatric procedure for SSO patients. SETTING: University hospital, Paris, France...
October 11, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Melissa Hite, Crystal Johnson-Mann, Rana Pullatt
No abstract text is available yet for this article.
August 1, 2018: American Surgeon
German Viscido, Veronica Gorodner, Franco José Signorini, A Carolina Biasoni, Luciano Navarro, Graciela Rubin, Lucio Obeide, Federico Moser
BACKGROUND: Bariatric surgery is superior to medical treatment for type 2 diabetes mellitus (T2DM) control in obese patients. Reports in the literature have been mainly based on Roux-en-Y gastric bypass (RYGB) or adjustable gastric band. The aim of this study was to analyze mid- and long-term metabolic results after laparoscopic sleeve gastrectomy (LSG). METHODS: Obese patients with T2DM undergoing LSG were included in this study. Selection criteria for T2DM remission were: post-operatory fasting glucose (FG) level <100 mg/dL, and hemoglobin A1c (HbA1c) <6% without medication...
November 16, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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