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D Edholm, S Axer, J Hedberg, M Sundbom
BACKGROUND AND AIMS: Unsatisfactory weight loss after gastric bypass or sleeve gastrectomy in super-obese patients (body mass index > 50) is a growing concern. Biliopancreatic diversion with duodenal switch results in greater weight loss, but is technically challenging to perform, especially as a laparoscopic procedure (Lap-DS). The aim of this study was to compare perioperative outcomes of Lap-DS and the corresponding open procedure (O-DS) in Sweden. MATERIAL AND METHODS: The data source was a nationwide cohort from the Scandinavian Obesity Surgery Registry and 317 biliopancreatic diversion with duodenal switch patients (mean body mass index = 56...
October 7, 2016: Scandinavian Journal of Surgery: SJS
Andrea Porta, Alberto Aiolfi, Cinzia Musolino, Ilaria Antonini, Marco Antonio Zappa
BACKGROUND: Laparoscopic sleeve gastrectomy has gained a wide acceptance in the surgical community with an increasing popularity in the field of bariatric surgery. Simultaneously more surgeons have become acquainted with the single port techniques and sleeve gastrectomy has been regarded as an ideal field of application. Literature is scarce about operative and clinical outcomes of single port sleeve gastrectomy compared to conventional laparoscopy. The primary purpose of the study was to compare operative outcomes in the two study groups...
September 30, 2016: Obesity Surgery
Lars Nelson, Rena C Moon, Andre F Teixeira, Manoel Galvão, Almino Ramos, Muhammad A Jawad
Background: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) was introduced into bariatric surgery by Sanchez-Pernaute et al. as an advancement of the biliopancreatic diversion with duodenal switch. Aim: To evaluate the SADI-S procedure with regard to weight loss, comorbidity resolution, and complication rate in the super obese population. Methods: A retrospective chart review was performed on initial 72 patients who underwent laparoscopic or robot-assisted laparoscopic SADI-S between December 17th, 2013 and July 29th, 2015...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Mauro Zago, Samantha Bozzo, Andrea Centurelli, Alessandro Giovanelli, Michele Ciocca Vasino
AIM: To report about an additional case of biliary ileus after bariatric surgery is reported and extensively reviewing the literature on this topic. MATERIAL OF STUDY: We reviewed the literature and found three cases of gallstone ileus (GI) that occurred after bariatric surgery. DISCUSSION: A 41 year old patient presented a GI eight years after a biliointestinal bypass (BIB) for morbid obesity. The patient complained of abdominal pain for two weeks...
2016: Annali Italiani di Chirurgia
Jakub Kuchinka, Łukasz Nawacki, Piotr Bryk, Jarosław Matykiewicz, Iwona Wawrzycka, Dorota Kozieł, Tomasz Rogula, Stanisław Głuszek
UNLABELLED: Obesity, at present, seems to be a very serious health problem all over the world. The surgery is said to be the most successful treatment of obesity. With the increase in the quantity of conducted bariatric procedures, the number of revision treatments increases as well. The aim of the study was to analyze the indications, results and complications after repeated bariatric surgeries. MATERIAL AND METHODS: The repeated bariatric procedures performed in 2009-2015 have been retrospectively analyzed...
March 1, 2016: Polski Przeglad Chirurgiczny
Emanuele Rausa, Luigi Bonavina, Emanuele Asti, Maddalena Gaeta, Cristian Ricci
Morbid obesity is a life threatening condition. Currently, surgery represents the only effective and durable therapeutic option to treat it. The first aim of the study was to estimate and compare the major surgical complications and the 30-day rate of mortality between laparoscopic and open Roux-en-Y gastric bypass (LRYGB and RYGB). The second aim was to evaluate the change in outcomes, complications, and deaths, with increased experience over the time period of the review. A random effect of the meta-analysis and meta-regression was used to evaluate surgical complications (i...
August 2016: Obesity Surgery
Katherine J L Suter, Niruben Rajasagaram, Peter Nottle
The laparoscopic adjustable gastric band (LAGB) is a widely performed procedure for the morbid obesity epidemic. Despite its low mortality compared with other mainstream bariatric surgeries, it is not without its complications. The authors report a late and rare complication of a small bowel obstruction in a 52-year-old woman from an LAGB placed for 2 years. She was diagnosed clinically and radiologically with a small bowel obstruction. However, in the setting of an LAGB, this became a closed-loop obstruction...
2016: Journal of Surgical Case Reports
Alexandre Descloux, Giacinto Basilicata, Antonio Nocito
Introduction. Laparoscopic Roux-en-Y gastric bypass (LRYGBP) is a common procedure in obesity surgery. The aim of an antecolic approach is to reduce the rate of internal herniation. Our aim is to make bariatric surgeons aware of another possible complication of antecolic LRYGBP. Methods and Results. We present a case report of omental torsion 24 months after antecolic LRYGBP presenting as an acute abdomen, suggesting appendicitis. During diagnostic laparoscopy, omental infarction due to torsion was observed...
2016: Case Reports in Surgery
Maria Careaga, Enric Esmatjes, Isabel Nuñez, Judit Molero, Josep Vidal, Lilliam Flores
BACKGROUND: Nocturnal hypertension (night systolic [S]/diastolic [D] blood pressure [BP]≥120/70 mm Hg), nondipper status (nocturnal BP fall<10% of daytime values), and pulse pressure ([PP]; difference between 24-h SBP and DBP readings) are associated with increased risk of cardiovascular disease. We evaluated the 1-year effect of significant surgical weight loss (WL) on abnormal BP patterns in patients with and without hypertension and identified the factors involved. SETTING: University hospital, Spain...
December 29, 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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
Ramon Vilallonga, José Manuel Fort, Enric Caubet, Oscar Gonzalez, José Maria Balibrea, Andrea Ciudin, Manel Armengol
Staged bariatric procedures in high risk patients are a common used strategy for morbid obese patients nowadays. After previous sleeve gastrectomy, surgical treatments in order to complete weight loss or comorbidities improvements or resolutions are possible. One strategy is to perform a novel technique named SADI (single anastomosis duodenoileal bypass-sleeve). We present the technique for totally intracorporeal robotically assisted SADI using five ports and a liver retractor. We aim to see if the robotic technology offers more advantageous anastomosis and dissection obtained by the robotic approach in comparison to standard laparoscopy...
2015: Journal of Obesity
Lindsay E Kuo, Kristina D Simmons, Noel N Williams, Rachel R Kelz
BACKGROUND: Obesity is a significant public health problem in the United States. Despite the known benefits of bariatric surgery, most patients eligible for bariatric surgery do not receive it. Access to minimally invasive bariatric surgery (MIS), the surgical gold standard, may be a limitation. OBJECTIVES: We investigated geographic variation in the utilization of laparoscopy for bariatric surgical procedures. METHODS: We utilized a unique 3-state inpatient database...
January 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
S Müller, N Runkel
INTRODUCTION: The increasing number of morbidly obese patients leads to a rising number of bariatric procedures in Germany. The operative techniques are highly standardized but such a standardization is lacking for the management of postoperative complications such as stenosis and ulceration after Roux-en-Y gastric bypass (RYGB) surgery and sleeve gastrectomy (SG). METHODS: The current literature is reviewed and a complication management is developed and presented in this article...
September 2015: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Gabriel Chan, Pierre Garneau, Roy Hajjar
The prevalence of obesity in patients with chronic kidney failure and renal transplant candidates has paralleled the epidemic in the general population. The associated risks of surgical complications and long-term cardiovascular death are significant: most transplant centers consider obesity a relative contra-indication for transplant. Few studies have focused on conservative weight loss strategies in transplant patients. Studies using administrative databases have found that only a minority of wait-listed patients lose weight and with no apparent benefit to transplant outcomes...
2015: Canadian Journal of Kidney Health and Disease
Jakob Hedberg, Hanna Zacharias, Lars Janson, Magnus Sundbom
BACKGROUND: As most bariatric procedures are performed by laparoscopy, hospital stay is exceptionally short, despite the habitus of patients and the rather extensive intra-abdominal surgery. To facilitate postoperative mobilization, most patients are given repeated single doses of morphine, a drug with several side effects. We aimed to evaluate the effect of preoperative treatment with a tablet of slow-release morphine (SRM) on postoperative analgesic consumption and length of stay (LOS) in laparoscopic gastric bypass (LGBP)...
April 2016: Obesity Surgery
Lionel Rebibo, Abdennaceur Dhahri, Cyril Chivot, Cosse Cyril, Thierry Yzet, Jean-Marc Regimbeau
BACKGROUND: Obesity is recognized as a risk factor for trocar site hernia (TSH) after laparoscopic surgery. Some recent studies have reported a TSH rate after bariatric surgery ranging from 0% to 1.6% using clinical evaluation and may underestimate the TSH rate. The objective of this study was to evaluate the TSH rate after sleeve gastrectomy (SG) by abdominal computed tomography (CT) scan. METHODS: A retrospective review of all patients who underwent first-line SG and abdominal CT scan between March 2004 and February 2014 was performed...
July 2015: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Jérémie Thereaux, Charles Roche, Jean-Pierre Bail
PURPOSE: Laparoscopic gastric bypass (LRYGB) is considered as the gold standard procedure for morbid obesity because of sustainable weight loss and coexisting conditions improvements (Sjostrom L et al. The New England journal of medicine 351(26):2683-93, 2004 [1]; Thereaux J et al. Surg Obesity Related Dis: Off J Am Soc Bariatric Surg, 2014 [2]). However, there are some concerns with the late risk of gastrojejunal anastomotic stenosis and of small bowel obstruction (Hamdan K et al. 98(10):1345-55, 2011 [3])...
May 2015: Obesity Surgery
Enrique Lanzarini, Xavier Nogués, Albert Goday, David Benaiges, Marta de Ramón, Montserrat Villatoro, Manuel Pera, Luis Grande, José Manuel Ramón
BACKGROUND: We assessed the need of vitamin D supplementation to achieve normal 25-hydroxyvitamin D (25[OH]D) levels after bariatric surgery and whether there were differences between laparoscopy sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: A total of 164 morbid obese patients undergoing bariatric surgery from January 2008 to June 2011 were followed for 2 years. Serum levels of 25(OH)D and intact parathyroid hormone (iPTH) were measured preoperatively and at 3, 6, 9, 12, 18, and 24 months after operation...
September 2015: Obesity Surgery
Kenkichi Hashimoto, Yosuke Seki, Kazunori Kasama
BACKGROUND: Obesity patients sometimes have gastric submucosal tumors (SMTs). Surgical excision is recommended in cases of SMTs with suspected malignancy or other reasons making follow-up difficult. Laparoscopic intragastric surgery (LIGS) has recently achieved good results in the treatment of gastric SMTs, especially near the esophagogastric junction (EGJ). This procedure has enabled either preservation of the stomach or minimization of the extent of partial resection. METHODS: The patient is a 43-year-old female with BMI of 48...
March 2015: Obesity Surgery
Fabio R Thuler, Wilson R de Freitas, Elias J Ilias, Paulo Kassab, Carlos Alberto Malheiros
BACKGROUND: Laparoscopy for bariatric surgery became the surgery of choice for surgeons worldwide. However, it is also more difficult to learn and has a great potential for complications. The specific training is fundamental to maintain the benefits without increasing the complications. This study presents a laparoscopic surgery training method for the treatment of obesity and to analyze its efficiency. METHOD: A training program for 36 surgeons with experience in open bariatric surgery was proposed, and the surgical results of their first laparoscopic surgeries were accompanied as for greater complications, such as death, intestinal obstruction, bleeding and fistula within the first 30 days...
2014: BMC Surgery
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