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Roux en Y Gastric Bypass

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https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#1
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#2
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726143/endoscopic-management-of-post-laparoscopic-sleeve-gastrectomy-stenosis
#3
Valérie Deslauriers, Amélie Beauchamp, Fabio Garofalo, Henri Atlas, Ronald Denis, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is the most popular bariatric surgery worldwide. Gastric sleeve stenosis is the most common postoperative complication, occurring in up to 3.9% of the cases. Current treatment options include endoscopic treatments, such as dilatations and stent placement as well as surgical revisions such as laparoscopic Roux-en-Y gastric bypass (LRYGB), wedge gastrectomy or seromyotomy. METHODS: A retrospective analysis of our prospectively collected therapeutical endoscopy database was performed between January 2014 and February 2017...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726136/robotic-versus-laparoscopic-stapling-during-robotic-roux-en-y-gastric-bypass-surgery-a-case-matched-analysis-of-costs-and-clinical-outcomes
#4
Monika E Hagen, Minoa K Jung, Jassim Fakhro, Nicolas C Buchs, Leo Buehler, Jona M Mendoza, Philippe Morel
BACKGROUND: The purpose of this analysis is to compare the robotic EndoWrist Stapling System (EWSS) 45 mm (Intuitive Surgical Inc. Sunnyvale, CA, USA) and the ECHELON FLEX(™) ENDOPATH(®) Staplers (EFES) 60 mm (Ethicon, Cincinnati, OH, USA) for gastric pouch formation during robotic gastric bypass surgery. METHODS: Patients who underwent robotic gastric bypass surgery with stapling using EWSS were matched with patients who underwent the same procedure with the EFES...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28725999/surgical-anti-reflux-options-beyond-fundoplication
#5
REVIEW
Dan Azagury, John Morton
PURPOSE OF REVIEW: This paper provides an overview of current and future surgical interventions available for the management of gastroesophageal reflux disease (GERD) beyond the well established and recognized fundoplication. Review the current indications and outcomes of these surgical procedures. RECENT FINDINGS: Fundoplication has been a cornerstone of the surgical management of GERD. However, other effective surgical options exist and can be considered based on prior interventions as well as patient, anatomical or other factors...
July 2017: Current Gastroenterology Reports
https://www.readbyqxmd.com/read/28725979/effect-of-weight-loss-after-bariatric-surgery-on-thyroid-stimulating-hormone-levels-in-patients-with-morbid-obesity-and-normal-thyroid-function
#6
João Sérgio Neves, Sofia Castro Oliveira, Pedro Souteiro, Jorge Pedro, Daniela Magalhães, Vanessa Guerreiro, Rita Bettencourt-Silva, Maria Manuel Costa, Ana Cristina Santos, Joana Queirós, Ana Varela, Paula Freitas, Davide Carvalho
BACKGROUND: Several studies have reported that morbid obesity is associated with increased thyroid-stimulating hormone (TSH) levels. However, it is not clear what is the impact of bariatric surgery on postoperative thyroid function. The aim of this study was to evaluate the effect of weight loss after bariatric surgery on TSH levels in euthyroid patients with morbid obesity. METHODS: We performed a retrospective observational study of 949 euthyroid patients (86...
July 19, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28722299/cost-and-health-care-utilization-implications-of-bariatric-surgery-versus-intensive-lifestyle-and-medical-intervention-for-type-2-diabetes
#7
Souvik Banerjee, Louis P Garrison, David R Flum, David E Arterburn
OBJECTIVE: The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is based on 2-year follow-up of a small randomized controlled trial (RCT); adult patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser Permanente Washington...
July 19, 2017: Obesity
https://www.readbyqxmd.com/read/28721194/successful-laparoscopic-repair-of-gastro-gastric-fistula-following-roux-en-y-gastric-bypass-at-harlem-community-hospital
#8
Saqib Saeed, Sara Alothman, Amrita Persaud, Sanjiv Gray, Leaque Ahmed
Gastro-gastric fistula is a communication between the gastric remnant and gastric pouch. It is a rare complication of Roux-en-Y gastric bypass. It is caused by anastomotic leak, marginal ulcers, distal obstruction or erosion from foreign body. In this case report, we are presenting a successful laparoscopic repair of gastro-gastric fistula in a patient who presented with weight gain after initial loss.
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28718091/nutritional-and-micronutrient-care-of-bariatric-surgery-patients-current-evidence-update
#9
REVIEW
Michael A Via, Jeffrey I Mechanick
PURPOSE OF REVIEW: The continued success of bariatric surgery to treat obesity and obesity-associated metabolic conditions creates a need for a strong understanding of clinical nutrition both before and after these procedures. RECENT FINDINGS: Surgically induced alteration of gastrointestinal physiology can affect the nutrition of individuals, especially among those who have undergone malabsorptive procedures. While uncommon, a subset of patients may develop protein-calorie malnutrition...
July 17, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28717859/estimated-costs-of-clinical-and-surgical-treatment-of-severe-obesity-in-the-brazilian-public-health-system
#10
Paula Rosales Zubiaurre, Luciana Ribeiro Bahia, Michelle Quarti Machado da Rosa, Roberto Pereira Assumpção, Alexandre Vontobel Padoin, Samanta Pereira Sussembach, Everton Nunes da Silva, Claudio Corá Mottin
BACKGROUND: Obesity is a major global epidemic and a burden to society and health systems. This study aimed to estimate and compare the anual costs of clinical and surgical treatment of severe obesity from the perspective of the Brazilian Public Health System. METHODS: An observational and cross-sectional study was performed in three reference centers. Data collection on health resources utilization and productivity loss was carried out through an online questionnaire...
July 17, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28716563/laparoscopic-revision-of-transoral-endoscopic-vertical-gastroplasty-to-roux-en-y-gastric-bypass
#11
Katherine M Meister, Charlotte M Horne, Philip R Schauer
No abstract text is available yet for this article.
March 10, 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28715057/the-impact-of-bariatric-surgery-on-health-outcomes-wellbeing-and-employment-rates-analysis-from-a-prospective-cohort-study
#12
M Riccò, F Marchesi, F Tartamella, C Rapacchi, V Pattonieri, A Odone, C Forlini, L Roncoroni, C Signorelli
PURPOSE: Morbid obesity is associated with several comorbidities that often impair patients' ability to obtain and keep a job and that, eventually, could hinder their fitness to work. This study aimed at determining whether the employment status of morbidly obese patients may be positively affected by bariatric surgery. METHODS: A total of 30 morbidly obese patients who underwent Roux-en-Y gastric bypass (RYGB) from March 2014 to March 2015 were prospectively evaluated...
September 2017: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/28713862/metabolic-surgery-gastric-bypass-for-the-treatment-of-type-2-diabetes-mellitus
#13
REVIEW
Maria Del Pilar Quevedo, Mariano Palermo, Edgardo Serra, Marianela A Ackermann
Type 2 diabetes mellitus (T2DM) is one of the largest health emergencies of the 21st century given the worldwide increase of obesity during the last decades and its close association. T2DM is an inherited, polygenic and chronic disease caused by the interaction between several genetic variants in genes and the environment. The continuous search for new and more effective tools to achieve appropriate glycemic control became imperative in order to reduce long-term complications and mortality rates related to T2DM...
2017: Translational Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28713063/radiofrequency-ablation-for-the-treatment-of-weight-regain-after-roux-en-y-gastric-bypass-surgery
#14
Julian A Abrams, Sri Komanduri, Nicholas J Shaheen, Zengri Wang, Richard I Rothstein
BACKGROUND AND AIMS: Roux-en-Y gastric bypass (RYGB) surgery is an established modality for the treatment of morbid obesity. However, approximately one-quarter of patients experience weight regain after initially successful weight loss. Endoscopic therapy targeting the gastric remnant pouch represents a novel potential strategy to re-induce weight loss in this population. We performed a pilot trial of radiofrequency ablation (RFA) of the gastric remnant pouch after RYGB to determine feasibility, safety and efficacy for weight loss...
July 13, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28707016/patterns-of-reoperation-after-failed-fundoplication-an-analysis-of-9462-patients
#15
Nabeel R Obeid, Maria S Altieri, Jie Yang, Jihye Park, Kristie Price, Andrew Bates, Aurora D Pryor
BACKGROUND: Little is known about the choice of reoperation after failed fundoplication for gastroesophageal reflux disease. Both redo fundoplication and conversion procedure to Roux-en-Y gastric bypass (RYGB) are safe and effective. We aimed to characterize the rates of different revisional procedures and to identify risk factors associated with failed fundoplication. METHODS: Using a statewide database, we examined records for patients who underwent fundoplication between 2000 and 2010...
July 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28703939/adaptation-of-the-by-band-randomized-clinical-trial-to-by-band-sleeve-to-include-a-new-intervention-and-maintain-relevance-of-the-study-to-practice
#16
C A Rogers, B C Reeves, J Byrne, J L Donovan, G Mazza, S Paramasivan, R C Andrews, S Wordsworth, J Thompson, J M Blazeby, R Welbourn
BACKGROUND: Recruitment into surgical RCTs can be threatened if new interventions available outside the trial compete with those being evaluated. Adapting the trial to include the new intervention may overcome this issue, yet this is not often done in surgery. This paper describes the challenges, rationale and methods for adapting an RCT to include a new intervention. METHODS: The By-Band study was designed in the UK in 2009-2010 to compare the effectiveness of laparoscopic adjustable gastric band and Roux-en-Y gastric bypass for severe obesity...
August 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28702741/massive-weight-loss-obtained-by-bariatric-surgery-affects-semen-quality-in-morbid-male-obesity-a-preliminary-prospective-double-armed-study
#17
Jinous Samavat, Giulia Cantini, Francesco Lotti, Alessandra Di Franco, Lara Tamburrino, Selene Degl'Innocenti, Elisa Maseroli, Erminio Filimberti, Enrico Facchiano, Marcello Lucchese, Monica Muratori, Gianni Forti, Elisabetta Baldi, Mario Maggi, Michaela Luconi
OBJECTIVES: The aim of this study is to evaluate the effect of massive weight loss on the seminal parameters at 6 months from bariatric surgery. DESIGN: Two-armed prospective study performed in 31 morbidly obese men, undergoing laparoscopic roux-en-Y-gastric bypass (n = 23) or non-operated (n = 8), assessing sex hormones, conventional (sperm motility, morphology, number, semen volume), and non-conventional (DNA fragmentation and seminal interleukin-8), semen parameters, at baseline and after 6 months from surgery or patients' recruitment...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28702740/large-bariatric-specific-stents-and-over-the-scope-clips-in-the-management-of-post-bariatric-surgery-leaks
#18
Hany Shehab, Emad Abdallah, Khaled Gawdat, Inas Elattar
BACKGROUND: Endoscopic stents are successful in the management of surgical leaks; however, stent migration remains a significant problem. In this study, we present our approach depending on a large bariatrics-specific stent (Mega stent) and over-the-scope clips in the management of post-bariatric surgery leaks. METHODS: A retrospective analysis of all patients with post-bariatric surgery leaks treated at our institution using an approach reliant on Mega stents and over-the-scope clips was conducted...
July 12, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28699145/shifts-in-food-preferences-after-bariatric-surgery-observational-reports-and-proposed-mechanisms
#19
REVIEW
Natasha Kapoor, Werd Al-Najim, Carel W le Roux, Neil G Docherty
PURPOSE OF REVIEW: Bariatric surgery is currently the most effective treatment for obesity. Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric procedure and results in long-term weight loss. Alterations in food preference and choices may contribute to the long-term benefits of RYGB. This manuscript reviews the available literature documenting changes in food preference in both humans and experimental animals after RYGB and discusses the current theory on the underlying mechanisms involved...
July 11, 2017: Current Obesity Reports
https://www.readbyqxmd.com/read/28696816/pre-existing-mesh-at-the-hiatus-in-revisional-surgery-does-not-result-in-increased-morbidity-a-case-control-evaluation
#20
Rana M Higgins, Max Schumm, Matthew E Bosler, Jon C Gould
BACKGROUND: Mesh is sometimes used to reinforce the hiatus during primary and reoperative fundoplication. This is a controversial practice as it is not clear that this leads to a decreased rate of failure of the hiatal closure, and concerns about morbidity related to the presence of mesh in this location exist. One of these concerns is that if reoperation is ever required (fundoplication herniates through the hiatus, for example), revisional surgery would be significantly more difficult and associated with a higher rate of morbidity than if mesh had not been placed at the hiatus in a previous procedure...
July 11, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
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