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https://www.readbyqxmd.com/read/29430230/mind-the-gap-successful-endoscopic-closure-of-a-large-gastric-sleeve-leak-using-an-endoscopic-stent-and-over-the-scope-clips
#1
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
https://www.readbyqxmd.com/read/29428692/routine-contrast-imaging-after-bariatric-surgery-and-the-effect-on-hospital-length-of-stay
#2
Uzma Rahman, Salvatore Docimo, Aurora D Pryor, Andrew Bates, Nabeel R Obeid, Konstantinos Spaniolas
BACKGROUND: Although multiple studies demonstrate that routine postoperative contrast studies have a low yield in diagnosing patients with early gastrointestinal (GI) leak after bariatric surgery, the practice pattern is unknown. Additionally, routine imaging may hinder procedural pathways that lead to accelerated postoperative discharge. OBJECTIVES: To report on the nationwide use of routine upper GI studies (UGI) and evaluate the effect on hospital resource utilization...
January 3, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29423166/endoscopic-use-of-epifix-dehydrated-human-amnion-chorion-membrane-dhacm-allograft-in-patients-with-gastric-leak-following-sleeve-gastrectomy
#3
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
https://www.readbyqxmd.com/read/29417487/perioperative-outcomes-of-laparoscopic-and-robotic-revisional-bariatric-surgery-in-a-complex-patient-population
#4
Katherine D Gray, Maureen D Moore, Adham Elmously, Omar Bellorin, Rasa Zarnegar, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: Utilization of the robotic platform has become more common in bariatric applications. We aim to show that robotic revisional bariatric surgery (RRBS) can be safely performed in a complex patient population with perioperative outcomes equivalent to laparoscopic revisional bariatric surgery (LRBS). METHODS: Retrospective review was conducted of adult patients undergoing laparoscopic revisional bariatric surgery (LRBS) or robotic revisional bariatric surgery (RRBS) at our institution from September 2007 to December 2016...
February 7, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29412237/technical-innovation-intragastric-single-port-sleeve-gastrectomy-igsg-a-feasibility-survival-study-on-porcine-model
#5
Oscar Estupinam, André Lacerda de Abreu Oliveira, Fernanda Antunes, Manoel Galvão, Henrique Phillips, Jussara Peters Scheffer, Marcelo Rios, Ricardo Zorron
PURPOSE: To perform technically the laparoscopic sleeve gastrectomy (LSG) using a unique Intragastric Single Port (IGSG) in animal swine model, evidencing an effective and safe procedure, optimizing the conventional technique. METHODS: IGSG was performed in 4 minipigs, using a percutaneous intragastric single port located in the pre-pyloric region. The gastric stapling of the greater curvature started from the pre-pyloric region towards the angle of His by Endo GIA™ system and the specimen was removed through the single port...
January 2018: Acta Cirúrgica Brasileira
https://www.readbyqxmd.com/read/29403579/computed-tomography-as-primary-postoperative-follow-up-after-laparoscopic-roux-en-y-gastric-bypass
#6
Tarik Delko, Diana Mattiello, Thomas Koestler, Urs Zingg, Silke Potthast
AIM: To evaluate upper abdominal computed tomography (CT) scan as primary follow-up after laparoscopic Roux-en-Y gastric bypass (LRYGB). METHODS: This prospective study was approved by the Ethical Committee of the State of Zurich, and informed consent was obtained from all patients. Sixty-one patients who underwent LRYGB received upper abdominal CT on postoperative day 1, with the following scan parameters: 0.6 mm collimation, 1.2 mm pitch, CareKV with reference 120 mAs and 120 kV, and 0...
January 28, 2018: World Journal of Radiology
https://www.readbyqxmd.com/read/29398036/what-matters-after-sleeve-gastrectomy-patient-characteristics-or-surgical-technique
#7
Vikrom K Dhar, Dennis J Hanseman, Brad M Watkins, Ian M Paquette, Shimul A Shah, Jonathan R Thompson
BACKGROUND: The impact of operative technique on outcomes in laparoscopic sleeve gastrectomy has been explored previously; however, the relative importance of patient characteristics remains unknown. Our aim was to characterize national variability in operative technique for laparoscopic sleeve gastrectomy and determine whether patient-specific factors are more critical to predicting outcomes. METHODS: We queried the database of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for laparoscopic sleeve gastrostomies performed in 2015 (n = 88,845)...
February 2, 2018: Surgery
https://www.readbyqxmd.com/read/29397639/staple-line-reinforcement-during-sleeve-gastrectomy-with-a-new-type-of-reinforced-stapler
#8
Imad El Moussaoui, Augustin Limbga, Abdelilah Mehdi
BACKGROUND: Bleeding and staple-line leak, are the most common complications of laparoscopic sleeve gastrectomy. To decrease the incidence of this complications, a variety of intra-operative reinforcement of staple line are used. Reinforced GIA is a new automatic suture device with pre-attached synthetic tissue reinforcement, but no study has evaluated its use in sleeve gastrectomy. The objective of this study is to evaluate the efficacy and safety of this new staple line reinforcement technique in laparoscopic sleeve gastrectomy...
February 1, 2018: Minerva Chirurgica
https://www.readbyqxmd.com/read/29370996/endoscopic-stent-placement-for-treatment-of-sleeve-gastrectomy-leak-a-single-institution-experience-with-fully-covered-stents
#9
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
https://www.readbyqxmd.com/read/29354173/pulmonary-carcinoids-analysis-of-early-and-long-term-surgical-treatment-outcomes-in-a-group-of-90-patients
#10
Mariusz Kasprzyk, Jan Musiałkiewicz, Mikołaj Kolasiński, Kajetan Jagiełka, Wojciech Dyszkiewicz
Introduction: Over the years, pulmonary carcinoids have been treated as locally malignant tumors because of the favorable prognosis. It is currently known that the clinical course of the disease is mainly dependent on the carcinoid subtype. Aim: To analyze the early and long-term surgical treatment outcomes for typical and atypical carcinoids. Material and methods: A total of 90 patients were treated surgically for pulmonary carcinoid tumors in the years 2007-2015...
December 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/29333067/complications-of-staple-line-and-anastomoses-following-laparoscopic-bariatric-surgery
#11
REVIEW
Gianfranco Silecchia, Angelo Iossa
With over 600 million people being obese, and given the scientific demonstration of the advantages of surgical treatment, bariatric surgery is on the rise. The promising long-term results in terms of weight loss, and particularly in relation to comorbidities and the control/cure rate, mean that the number of procedures performed in all countries remains high. However, the risk of potentially complex or fatal complications, though small, is present and is related to the procedures per se. This review is a guide for bariatric and/or general surgeons, offering a complete overview of the pathogenesis of anastomosis and staple line following the most common laparoscopic bariatric procedures: sleeve gastrectomy, gastric bypass, and mini-gastric bypass...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
https://www.readbyqxmd.com/read/29313318/gastric-leaks-after-sleeve-gastrectomy-focus-on-pathogenetic-factors
#12
Francesco Frattini, Roberto Delpini, Davide Inversini, Vincenzo Pappalardo, Stefano Rausei, Giulio Carcano
As reported by The International Federation for the Surgery of Obesity (IFSO) worldwide survey on bariatric surgery, sleeve gastrectomy has become the second most performed bariatric/metabolic procedure in the world just after gastric bypass. If we consider complications, despite a recent systematic review and meta-analysis that reported a substantial decrease in sleeve gastrectomy complication rates, leaks after sleeve gastrectomy still rate between 0 and 18%. Unlike the leaks of other types of gastrointestinal surgery, leaks after sleeve gastrectomy are challenging in diagnosis and treatment and can lead to sepsis, multiple organ failure, and even death...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29310815/endoluminal-stenting-for-the-management-of-leak-following-sleeve-gastrectomy-and-loop-duodenojejunal-bypass-with-sleeve-gastrectomy
#13
Ying-Nan Tsai, Hsiu-Po Wang, Chih-Kun Huang, Po-Chin Chang, I-Chang Lin, Chi-Ming Tai
Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy...
January 2018: Kaohsiung Journal of Medical Sciences
https://www.readbyqxmd.com/read/29277390/guiding-the-non-bariatric-surgeon-through-complications-of-bariatric-surgery
#14
N Contival, B Menahem, T Gautier, Y Le Roux, A Alves
Complications in bariatric surgery are varied; they are severe at times but infrequent. They may be surgical or non-surgical, and may occur early or late. The goal of this systematic review is to inform and help the attending physician, the emergency physician and the non-bariatric surgeon who may be called upon to manage surgical complications that arise after adjustable gastric band (AGB), sleeve gastrectomy (SG), or gastric bypass (GBP). Data from evidence-based medicine were extracted from the literature by a review of the Medline database and also of the most recent recommendations of the learned societies implicated...
December 22, 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29249586/medium-to-long-term-outcomes-of-bariatric-surgery-in-older-adults-with-super-obesity
#15
Aly Elbahrawy, Alexandre Bougie, Sarah-Eve Loiselle, Sebastian Demyttenaere, Olivier Court, Amin Andalib
BACKGROUND: Indications and outcomes of bariatric surgery in older adults suffering from morbid obesity remain controversial. We aimed to evaluate safety and medium to long-term outcomes of bariatric procedures in this patient population. SETTING: University Hospital, Canada. METHODS: This is a single-center retrospective study of a prospectively collected database. We included patients aged ≥60 years who underwent sleeve gastrectomy, Roux-en-Y gastric bypass, or biliopancreatic diversion with duodenal switch between January 2006 and December 2014 and had at least 2 years of follow-up...
November 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/29248980/delayed-intra-splenic-abscess-a-specific-complication-following-laparoscopic-sleeve-gastrectomy
#16
Fajer Nassour, Naim Michel Schoucair, Hadrien Tranchart, Sophie Maitre, Ibrahim Dagher
BACKGROUND: Delayed intra splenic abscess after laparoscopic sleeve gastrectomy (LSG) is a very rare complication with poor manifestations. METHODS: We present three cases of delayed intrasplenic abscess which were managed in our departmentof minimal invasive surgery. DISCUSSION: Splenic abscess may occur in the early post-operative period following LSG; it is usually an extra splenic event after the gastric leak or an infected hematoma. In our cases, two patients had an asymptomatic ischemic demarcation in the upper part of the spleen...
February 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29246457/the-effectiveness-and-safety-of-laparoscopic-sleeve-gastrectomy-with-different-sizes-of-bougie-calibration-a-systematic-review-and-meta-analysis
#17
REVIEW
Yao Wang, Xiao-Yan Yi, Li-Lin Gong, Qi-Fu Li, Jun Zhang, Zhi-Hong Wang
OBJECTIVES: This systematic review and meta-analysis was performed to compare the influence of different calibrating bougie sizes on clinical outcomes in laparoscopic sleeve gastrectomy (LSG) for patients with obesity. MATERIALS AND METHODS: A systematic review of the literature was performed using the key words: "laparoscopic sleeve gastrectomy", "bougie size", "calibration", "obesity", and "obese" for searches of electronic databases up to October 2017. Clinical characteristics such as, the percentage of excess weight loss (%EWL), overall complications, gastrointestinal leaks, gastroesophageal reflux disease (GERD) were pooled by meta-analysis...
December 12, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/29237137/endoscopic-abscess-septotomy-a-less-invasive-approach-for-the-treatment-of-sleeve-gastrectomy-leaks
#18
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
https://www.readbyqxmd.com/read/29235015/use-of-self-expandable-metal-stents-in-the-treatment-of-leaks-complicating-laparoscopic-sleeve-gastrectomy-a-cohort-study
#19
Majid Abdularahman Almadi, Fahad Bamihriz, Othman Alharbi, Nahla Azzam, Ahmed Aljammaz, Mohanned Eltayeb, Salem Thaniah, Abdullah Aldohayan, Abdulrahman Aljebreen
BACKGROUND: Use of a self-expandable metal stent (SEMS) as an initial intervention for leaks after laparoscopic sleeve gastrectomy (LSG) has increased. We assessed the efficacy and safety of SEMS in the treatment of post-LSG leaks, and the determinants of repeated rounds of stenting. METHODS: A retrospective chart review was conducted at a university hospital in Saudi Arabia. The study included patients who developed leaks after undergoing LSG between October 2011 and April 2016...
December 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/29197192/laparoscopic-gastric-plication-for-the-treatment-of-morbid-obesity-by-using-real-time-imaging-of-the-stomach-pouch
#20
Cristian Borz, Tivadar Jr Bara, Tivadar Bara, Andras Suciu, Marton Denes, Bogdan Borz, Dorin Marian, Simona Muresan, Anca Bacarea, Mircea Muresan, Gabriela Jimborean
BACKGROUND: Bariatric surgery is a continuously evolving field. Laparoscopic greater curvature plication is a new investigational procedure used to treat patients with morbid obesity. The demand for this operation from the obese patients is also rising. The problem is that during gastric plication the exact dimensions and volume of the pouch are not known so frequently it is too large or too tight thus compromising the results. The aim of the study was to identify the parameters that can improve the outcomes after this procedure...
2017: Annali Italiani di Chirurgia
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