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bariatric , obesity , gastric , stomach

Nickolas Kipshidze, Anaka Prakash, Nodar Kipshidze, David Chakhunashvili, Zurab Kakabadze
BACKGROUND: Surgical treatment of obesity is characterized by both early and late complications, and thus, there is a need to develop safe and non-invasive techniques. Ghrelin is an orexigenic hormone produced by the fundus of the stomach, which may represent a novel target for obesity management. Unfortunately, numerous attempts to alter ghrelin levels have failed to present significant clinical results. We describe a novel procedure that involves modifying arterial blood flow to the gastric fundus for limiting plasma ghrelin levels...
October 8, 2016: Obesity Surgery
Luiz Claudio Lopes Chaves, Isabela Klautau Leite Chaves Borges, Maíra Danielle Gomes de Souza, Ian Passos Silva, Lyz Bezerra Silva, Marcelo Alexandre Prado Magalhães, Allan Herbert Feliz Fonseca, Josemberg Marins Campos
Background: The prevalence of Helicobacter pylori in obese candidates for bariatric surgery and its role in the emergence of inflammatory lesions after surgery has not been well established. Aim: To identify the incidence of inflammatory lesions in the stomach after bariatric surgery and to correlate it with H. pylori infection. Methods: This is a prospective study with 216 patients undergoing Roux-en-Y gastric bypass. These patients underwent histopathological endoscopy to detect H...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Eduardo Arevalo Vidal, Francisco Abarca Rendon, Trino Andrade Zambrano, Yudoco Andrade García, Mario Ferrin Viteri, Josemberg Marins Campos, Manoela Galvão Ramos, Almino Cardoso Ramos
Background: Intestinal malrotation is a rare congenital anomaly. In adults is very difficult to recognize due to the lack of symptoms. Diagnosis is usually incidental during surgical procedures or at autopsy. Aim: To review the occurrence and recognition of uneventful intestinal malrotation discovered during regular cases of bariatric surgeries. Methods: Were retrospectively reviewed the medical registry of 20,000 cases undergoing bariatric surgery, from January 2002 to January 2016, looking for the occurrence of intestinal malrotation and consequences in the intraoperative technique and immediate evolution of the patients...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Arif Ahmad, Jason Jorge Arellano, Ashish Agarwala, Zoe Ahmad, Zoha Ahmad
BACKGROUND: Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate exposure of the hiatus and the stomach. Currently used approaches utilize retractors that require additional incisions and prolong operative time. OBJECTIVES: A retrospective evaluation of the efficacy and safety of a percutaneous liver retractor in a large series of patients undergoing laparoscopic bariatric surgery. SETTING: Private practice, United States...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Nikkie van der Wielen, Givan Paulus, Mark van Avesaat, Ad Masclee, Jocelijn Meijerink, Nicole Bouvy
BACKGROUND: Bariatric surgery is an effective intervention strategy in obesity, resulting in sustained weight loss and a reduction of comorbidities. Gastroplication, using the articulating circular endoscopic stapler, was recently introduced as a transoral bariatric technique. This procedure reduces gastric volume and induced 34.9 % of excess weight loss in the first year (Paulus et al. Gastrointest Endosc. 81(2):312-20, 3). The aim of the present study was to gain insight in the long-term effects and underlying mechanisms of gastroplication by investigating differences in the genome-wide gastric and duodenal transcriptome before and 1 year after intervention...
September 13, 2016: Obesity Surgery
Stacy A Brethauer, Julietta Chang, Manoel Galvao Neto, Jan Willem Greve
BACKGROUND: Obesity and type 2 diabetes (T2D) continue to be growing epidemics worldwide. Although bariatric surgery remains the most effective and durable treatment for both of these chronic diseases, there is a need for therapies with risk and benefit profiles between medication and standard surgical procedures. Currently there are several endoscopic and minimally invasive therapies available worldwide to treat T2D. OBJECTIVE: To review the current evidence regarding the safety and efficacy of medical devices to treat T2D...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Marzieh Salehi, David A D'Alessio
Bariatric surgery is the most effective treatment for obesity and diabetes. The 2 most commonly performed weight-loss procedures, Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy, improve glycemic control in patients with type 2 diabetes independent of weight loss. One of the early hypotheses raised to explain the immediate antidiabetic effect of RYGB was that rapid delivery of nutrients from the stomach pouch into the distal small intestine enhances enteroinsular signaling to promote insulin signaling...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Alexander S Pasciak, Austin C Bourgeois, Ben E Paxton, Laurentia Nodit, Patricia N Coan, Dara Kraitchman, Sandra S Stinnett, Vijay M Patel, Yingli Fu, Joleen K Adams, M Katherine Tolbert, Cassie N Lux, Aravind Arepally, Yong C Bradley
PURPOSE: To evaluate feasibility of left gastric artery (LGA) yttrium-90 ((90)Y) radioembolization as potential treatment for obesity in a porcine model. MATERIALS AND METHODS: This study included 8 young female pigs (12-13 weeks, 21.8-28.1 kg). Six animals received infusions of (90)Y resin microspheres (46.3-105.1 MBq) into the main LGA and the gastric artery arising from the splenic artery. Animal weight and serum ghrelin were measured before treatment and weekly thereafter...
October 2016: Journal of Vascular and Interventional Radiology: JVIR
Paul R Burton, Geraldine J Ooi, Cheryl Laurie, Kalai Shaw, Paul E O'Brien, Andrew Smith, Peter D Nottle, Wendy A Brown
BACKGROUND: Oesophageal cancer following bariatric surgery adds significant complexity to an already challenging disease. There is limited data on the diagnosis, presentation and management in these complex cases. METHODS: A retrospective cohort study on prospectively collected data over 10 years was conducted. The oesophago-gastric cancer database was searched for patients with prior bariatric surgery. Data were retrieved on bariatric and cancer management. RESULTS: We identified nine patients with oesophageal or gastro-oesophageal junction adenocarcinoma after bariatric surgery...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Rodolfo J Oviedo, Chase W Sofiak, Bruce M Dixon
INTRODUCTION: Achalasia is a condition that occurs when the lower esophageal sphincter (LES) fails to properly relax, combined with slowing/failure of esophageal peristalsis. This is seen clinically by not allowing solids and liquids to pass easily into the stomach. Achalasia is not historically associated with morbid obesity, yet dual treatment of morbid obesity and achalasia is becoming more prominent due to the worldwide obesity epidemic. PRESENTATION OF CASE: Achalasia is typically a disease that affects non-obese adults over the age of 55, which makes the discussion of this case report unique in that our patient is a 23 year-old woman who successfully underwent per-oral endoscopic myotomy (POEM) in preparation for a future laparoscopic sleeve gastrectomy...
2016: International Journal of Surgery Case Reports
Leigh A Peterson
Obesity is the most widespread nutritional problem globally. Bariatric surgery is the preeminent long-term obesity treatment. Bariatric procedures manipulate the intestines to produces malabsorption and/or restrict the size of the stomach. The most enduring bariatric procedure is the Roux-en-Y gastric bypass, which utilizes both restriction (small stomach pouch) and malabsorption (duodenum bypass). The in-vogue procedure is the vertical sleeve gastrectomy - resection of the greater curvature of the stomach (predominantly restrictive)...
October 2016: Minerva Chirurgica
Jaber O Al Shammari, Nimer Al-Shadidi, Ahmad J Abdulsalam, Abdullah E Al-Daihani
INTRODUCTION: Gastric lipomas are rare benign mesenchymal tumors of the stomach. CASE REPORT: We report a 41 year old, morbid obese male, admitted for elective laparoscopic sleeve gastrectomy. Thorough preoperative assessment revealed a gastric lipoma in the antrum of the stomach measuring 3×3cm. Due to the patient's preference, surgical resection of the lipoma was done along with the laparoscopic sleeve gastrectomy procedure. DISCUSSION: In our case, we report a rare case of submucosal gastric lipoma successfully removed during a laparoscopic sleeve gastrectomy...
2016: International Journal of Surgery Case Reports
Gianmattia Del Genio, Michel Gagner, Paolo Limongelli, Salvatore Tolone, Dimitri Pournaras, Carel W le Roux, Luigi Brusciano, Anna Licia Mozzillo, Federica Del Genio, Ludovico Docimo
BACKGROUND: Nutrient interaction with the mid-gut may play a role in improving type 2 diabetes mellitus (T2D) after bariatric surgery. However, Roux-en-Y gastric bypass, biliopancreatic diversion, and sleeve gastrectomy include diversion of food from the duodenum and/or partial gastrectomy. Biliointestinal bypass (BIBP) was introduced to eliminate the major side effects of jejunoileal bypass. It does not involve any change to the anatomy of the stomach or the duodenum. A prospective evaluation of the role of BIBP in glycemic control has not been reported...
May 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Brian Mitzman, Daniel Cottam, Richie Goriparthi, Samuel Cottam, Hinali Zaveri, Amit Surve, Mitchell S Roslin
BACKGROUND: Although the duodenal switch (DS) has been the most effective weight loss surgical procedure, it is a small minority of the total bariatric surgical cases performed. Modifications that can make the operation technically simpler and reduce a long-term risk of short bowel syndrome would be of benefit. The aim of this study was to detail our initial experience with a modified DS called stomach intestinal pylorus sparing (SIPS) procedure. METHODS: Data from patients who underwent a primary SIPS procedure performed by two surgeons at two centers from January 2013 to August 2014 were retrospectively analyzed...
September 2016: Obesity Surgery
M Kasalický, E Koblihová
INTRODUCTION: In 2016 60 years will have elapsed from the first publication by Nissen about his surgical method of 360° fundoplication around distal esophagus and its final effect. Nissens fundoplication is currently the most common surgical method for the gastroesophageal reflux (GER) and hiatal hernia (HH) probably. Incidence of HH ranges between 25-50% in the western population. Current prevalence of GER ranges between 4-10% in Europe and 5-7% in North America, but some studies report even 10-20%...
December 2015: Rozhledy V Chirurgii: Měsíčník Československé Chirurgické Společnosti
Ulysses Rosas, Harrison Hines, Daniel Rogan, Homero Rivas, John Morton
Bariatric surgery is an effective and enduring treatment for obesity. Sleeve gastrectomy (SG) has emerged as an increasingly prevalent surgical intervention. Further investigation is required to determine optimal standardization of SG. Data were collected prospectively for 64 patients who underwent a laparoscopic vertical SG between December 2010 and February 2013 at a single academic institution. Demographic, intraoperative, and postoperative (postop) data were collected for all patients including weighing each resected stomach...
December 2015: American Surgeon
Ameer Gomberawalla, Rami Lutfi
BACKGROUND: The laparoscopic sleeve gastrectomy (LSG) is the fastest rising bariatric procedure being performed in the United States. Some surgeons advocate for an intra-operative endoscopy for their leak test, while others utilize air via a form of an oral gastric tube. We present a case demonstrating the benefits of endoscopy intra-operatively as well as discuss our experience of 200 consecutive sleeve gastrectomies. CASE PRESENTATION: The case is a 37 years old female undergoing LSG for treatment for morbid obesity...
2015: Annals of Surgical Innovation and Research
J R A Skipworth, A E Fanshawe, M Hewitt, D A Raptis, E Efthimiou, W J B Smellie
INTRODUCTION: Laparoscopic adjustable gastric bands (LAGB) are placed around the superior aspect of the stomach to aid weight loss and co-morbidity resolution in morbidly obese patients. Slippage of the LAGB from its original position to lower in the fundus of the stomach leads to gastric obstruction, and sometimes ischaemia or perforation, necessitating LAGB repositioning or removal. This study aimed to identify the incidence of LAGB slippage, as well as predisposing factors that may influence its development...
July 2016: Obesity Surgery
Palanivelu Praveenraj, Rachel M Gomes, Saravana Kumar, Palanisamy Senthilnathan, Ramakrishnan Parthasarathi, Subbiah Rajapandian, Chinnusamy Palanivelu
BACKGROUND: Roux-en-Y gastric bypass (RYGB) may be a better option for morbidly obese patients with gastroesophageal reflux (GERD) for long-term reflux control. It is recommended after fundoplication if a patient is morbidly obese with GERD with failed fundoplication or if bariatric surgery is planned with a prior successful fundoplication (Kim et al., Am Surg 80(7):696-703, 2014; Kambiz Zainabadi, Surg Endosc. 22(12):2737-40, 2008). Complete takedown of the wrap to avoid stapling over the fundoplication creating an obstructed, septated pouch is needed (Kambiz Zainabadi, Surg Endosc...
January 2016: Obesity Surgery
Radu Pescarus, Ahmed M Sharata, Christy M Dunst, Eran Shlomovitz, Lee L Swanström, Kevin M Reavis
BACKGROUND: Roux-en-Y gastric bypass (RYGB) is considered to be an optimal surgical treatment option for GERD in the morbidly obese patient. Nevertheless, a subgroup of patients suffer from recurrent or persistent GERD after their gastric bypass. Unfortunately, limited treatment options are available in these patients. Fundoplication via mobilization of the remnant stomach and radiofrequency treatment of the lower esophageal sphincter have been described with some success. Our objective is to illustrate a safe and durable surgical option in the treatment of patients with medically refractory GERD post-RYGB...
May 2016: Surgical Endoscopy
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