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Laparoscopic surgery and Bariatric surgery

Wesley F Kim, Thomas Sonnanstine
BACKGROUND: Despite effectively treating obesity and its comorbidities, only a fraction of the growing obese population is evaluated for bariatric surgery. Aside from barriers including resources and social support, patients report personal experience with friends and relatives suffering poor outcomes after bariatric surgery. Rates of mortality, leaks, and strictures have decreased over the past 20 years, but few instances of gross surgeon error have been reported in the literature. Our objective is to report and demonstrate the revision of a critically shortened Roux limb in a patient with chronic nausea and dysphagia found to have a 15-cm Roux limb and briefly discuss its implications...
March 14, 2018: Obesity Surgery
Ji Yeon Park, Yong Jin Kim
BACKGROUND: Percentage of excess weight loss (%EWL) is the most common metric used after bariatric surgery. However, there has been consistent argument against its use since it varies significantly by initial body mass index (BMI). This study aimed to validate the newly suggested percentage of alterable weight loss (%AWL) metric in Korean patients. METHODS: A retrospective review of the prospectively established database at Soonchunhyang University Seoul Hospital identified 165 patients who underwent primary laparoscopic Roux-en-Y gastric bypass (RYGB) and had at least 2-year follow-up weight loss results after surgery...
March 12, 2018: Obesity Surgery
Usha K Coblijn, Sjoerd M Lagarde, Christel A L de Raaff, Bart A van Wagensveld, Ellen M A Smets
BACKGROUND: The decision to undergo bariatric surgery is multifactorial and made both by patient and doctor. Information is of the utmost importance for this decision. OBJECTIVE: To investigate the bariatric surgery patient's preferences regarding information provision in bariatric surgery. SETTING: A teaching hospital, bariatric center of excellence in Amsterdam, the Netherlands. METHODS: All patients who underwent a primary laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy between September 2013 and September 2014 were approached by mail to participate...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Uri Kaplan, Scott Penner, Forough Farrokhyar, Nicole Andruszkiewicz, Ruth Breau, Scott Gmora, Dennis Hong, Mehran Anvari
PURPOSE: Older age (> 60) has been considered a relative contraindication for bariatric surgery due to increased complication risk. This study examined the risks and benefits of bariatric surgery for patients older than 60 years in Canadian population. METHODS: This was a retrospective cohort study of the Ontario Bariatric Registry: a database recording peri-operative and post-operative outcomes of publicly funded bariatric surgeries across the province. Patients who completed 1 year follow-up, who underwent laparoscopic gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) between January 2010 and May 2013, were divided into older (> 60) and younger (> 60) cohorts, and outcomes were compared...
March 10, 2018: Obesity Surgery
Salman AlSabah, Eliana Al Haddad, Saud Al-Subaie, Shehab Ekrouf, Khaled Alenezi, Ahmad Almulla, Mohannad Alhaddad
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) has become the most performed bariatric procedure as of 2015. However, inadequate weight loss may present the need for revisional procedures. OBJECTIVES: The objective of this study was to analyze the efficacy of single-anastomosis gastric bypass (SAGB) in attaining successful weight loss following an initial LSG. METHODS: A retrospective analysis was performed on all patients who underwent LSG at Amiri Hospital, Kuwait from 2008 to 2017...
March 8, 2018: Obesity Surgery
Sandhya B Kumar, Barbara C Hamilton, Stephanie G Wood, Stanley J Rogers, Jonathan T Carter, Matthew Y Lin
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become popular due to its technical ease and excellent short-term results. Understanding the risk profile of LSG compared with the gold standard laparoscopic Roux-en-Y gastric bypass (LRYGB) is critical for patient selection. OBJECTIVES: To use traditional regression techniques and random forest classification algorithms to compare LSG with LRYGB using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Data Registry...
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
Rieko Kikuchi, Junichiro Irie, Nobuko Yamada-Goto, Eri Kikkawa, Yosuke Seki, Kazunori Kasama, Hiroshi Itoh
BACKGROUND AND OBJECTIVES: Bariatric surgery improves metabolic diseases and alters the intestinal microbiota in animals and humans, but different procedures reportedly have different impacts on the intestinal microbiota. We developed laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB) as an alternative to laparoscopic Roux-en-Y gastric bypass (LRYGB) in addition to laparoscopic sleeve gastrectomy (LSG) for Japanese patients with obesity. We investigated the precise change in the intestinal microbiota induced by these procedures in the present study...
March 5, 2018: Clinical Drug Investigation
Mohamed Hany, Mohammed Ibrahim
INTRODUCTION: Laparoscopic sleeve gastrectomy (LSG) is now a popular bariatric procedure worldwide with rising prevalence over the last decade. Staple line leak and bleeding are the most dangerous complications of LSG. Staple line reinforcement (SLR) by oversewing the staple line was suggested to reduce the incidence of leak and bleeding. We designed a randomized controlled prospective study to investigate the value of SLR by invaginating the whole staple line using unidirectional absorbable 3/0 V-Loc 180 sutures (Covidien, Mansfield, MA, USA) to no SLR in LSG...
March 5, 2018: Obesity Surgery
F Carbone, E Nulli Migliola, A Bonaventura, A Vecchié, S De Vuono, M A Ricci, G Vaudo, M Boni, F Dallegri, F Montecucco, G Lupattelli
BACKGROUND & AIMS: Gender-related differences represent an emerging investigation field to better understand obesity heterogeneity and paradoxically associated cardiovascular (CV) risk. Here, we investigated if high-sensitivity C-reactive protein (hs-CRP) might differently affect adiposity and predict the clinical response to bariatric surgery in obese males and females. METHODS AND RESULTS: In 110 morbidly obese patients undergoing laparoscopic sleeve gastrectomy, hs-CRP as well as anthropometric assessment of adiposity, completed by electric bioimpedance and ultrasonography quantification of visceral fat area (VFA), were measured before and one year after surgery...
February 2, 2018: Nutrition, Metabolism, and Cardiovascular Diseases: NMCD
Lizbeth Guilbert, Cristian J Ortiz, Omar Espinosa, Elisa M Sepúlveda, Tatiana Piña, Paul Joo, Carlos Zerrweck
BACKGROUND: The latest diabetes consensus identified obesity as key component of the metabolic syndrome. The role of bariatric surgery over such syndrome has been less explored with a lack of long term studies, and especially among Mexicans. METHODS: Retrospective study including patients with metabolic syndrome submitted to laparoscopic gastric bypass at a single institution with complete data after 24 months. The objective was to analyze the improvement of the syndrome and each component...
March 1, 2018: International Journal of Surgery
Maria S Altieri, Jie Yang, Lizhou Nie, Robin Blackstone, Konstantinos Spaniolas, Aurora Pryor
BACKGROUND: A primary measure of the success of a procedure is the whether or not additional surgery may be necessary. Multi-institutional studies regarding the need for reoperation after bariatric surgery are scarce. OBJECTIVES: The purpose of this study is to evaluate the rate of revisions/conversions (RC) after 3 common bariatric procedures over 10 years in the state of New York. SETTING: University Hospital, involving a large database in New York State...
December 29, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Hideo Takahashi, Matthew T Allemang, Andrew T Strong, Mena Boules, Zubaidah Nor Hanipah, Alfredo D Guerron, Kevin El-Hayek, John H Rodriguez, Matthew D Kroh
BACKGROUND: With the worldwide epidemic of obesity, an increasing number of bariatric operations and antireflux fundoplications are being performed. Despite low morbidity of the primary foregut surgery, completion gastrectomy may be necessary as a definitive procedure for complications of prior foregut surgery; however, the literature evaluating outcomes after completion gastrectomy with esophagojejunostomy (EJ) for benign diseases is limited. We present our experience of completion gastrectomy with Roux-en-Y EJ in the setting of benign disease at a single tertiary center...
March 1, 2018: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Shani Shenhar-Tsarfaty, Shiri Sherf-Dagan, Galia Berman, Muriel Webb, Asnat Raziel, Andrei Keidar, David Goitein, Nasser Sakran, Eti Zwang, Itzhak Shapira, David Zeltser, Shlomo Berliner, Ori Rogowski, Oren Shibolet, Shira Zelber-Sagi
BACKGROUND: Impaired sympathetic/parasympathetic response, expressed by elevated Acetylcholinesterase (AChE) is associated with obesity, metabolic syndrome and inflammation. However, the association between morbid obesity and AChE and the changes in cholinergic tone following bariatric laparoscopic sleeve gastrectomy (LSG) surgery-induced weight reduction were never analyzed. METHODS: Two studies are presented; the first (the "apparently healthy cohort") was a cross-sectional study and the second (the "LSG cohort") was a prospective-cohort study with 12 months of follow-up...
February 3, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Zvia Burgansky-Eliash, Asaf Achiron, Idan Hecht, Mordechai Shimonov
PURPOSE: To investigate the effects of bariatric surgery on intraocular pressure (IOP). METHODS: We prospectively enroled consecutive obese patients who underwent a laparoscopic sleeve gastrectomy procedure. We measured IOP prior to and 3-6 months following surgery and recorded medical and demographical parameters. RESULTS: Thirty-two patients completed all evaluations. Mean age was 40.5 ± 12 and 24 (75%) were men. Following surgery, mean body-mass index (BMI) decreased from 42 ± 6 to 31 ± 8 (p < 0...
February 28, 2018: Acta Ophthalmologica
Arnold W van de Laar, A S van Rijswijk, H Kakar, S C Bruin
BACKGROUND: Criteria for bariatric weight loss success are numerous. Most of them are arbitrary. None of them is evidence-based. Our objective was to determine their sensitivity and specificity. METHODS: Thirteen common bariatric weight loss criteria were compared to a benchmark reflecting the gold standard in bariatric surgery. We used an elaborate baseline BMI-independent weight loss percentile chart, based on retrospective data after laparoscopic Roux-en-Y gastric bypass (LRYGB), performed between 2007 and 2017...
February 27, 2018: Obesity Surgery
Kirit Arumalla, Vitish Singla, Sandeep Aggarwal, Harshit Garg, Ritesh Goel, Varidh Katiyar
Introduction: There is a worldwide increase in the prevalence of obesity among the adolescent population in India from 16.3% in 2001 to 19.3% in 2010. Recent evidence suggests that bariatric surgery leads to resolution of comorbidities and associated long-term complications in adolescent patients with morbid obesity. Aim: The aim of this study is to determine the impact of bariatric surgery on the weight loss and comorbidities of morbidly obese adolescents. Materials and Methods: A retrospective review of the data of 10 adolescent patients, who underwent Laparoscopic Sleeve Gastrectomy at our institute (tertiary care hospital), from July 2009 to July 2016 was carried out...
February 27, 2018: Journal of Minimal Access Surgery
G Campisciano, S Palmisano, C Cason, M Giuricin, M Silvestri, M Guerra, D Macor, N De Manzini, L S Crocé, M Comar
Intestinal microbiota analysis of obese patients after bariatric surgery showed that Proteobacteria decreased after laparoscopic sleeve gastrectomy (SG), while it increased after laparoscopic gastric bypass (LGB). Comparing to normal weight (NW) patients, obese patients that were selected for SG showed an almost equal amount of Firmicutes and Bacteroidetes and the ratio was not affected by the surgery. Obese patients before LGB showed a predominance of Bacteroidetes, whose amount regained a relative abundance similar to NW patients after surgery...
February 27, 2018: Beneficial Microbes
Michéle A Janse Van Vuuren, Esben Strodl, Katherine M White, Philip D Lockie
OBJECTIVES: Laparoscopic sleeve gastrectomy (LSG) incidence has increased worldwide. However, a proportion of patients achieve inadequate weight loss and some experience weight regain. Little is known of the influence of eating beliefs and behaviours in response to cravings on early weight loss trajectory. This study aimed to identify the post-surgery eating cravings that predicted patients not achieving excess weight loss outcome (EWL) at 6-8 months post-LSG. DESIGN: A total of 106 (80...
February 24, 2018: British Journal of Health Psychology
Ahmed Arifur Rahman, Ken Loi
Obesity is considered the most common nutritional disorder in Western countries and is related to multiple morbidity and mortality. There are different options for obesity treatment, including diet, behavioral therapy, medications, and surgery. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction. Currently, the intragastric balloon is one of the most common bariatric procedures in obese patients in Europe. Gastric perforation associated with intragastric balloon is a rare but dangerous complication...
January 31, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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