leak in bariatric surgery

BACKGROUND: We seek to determine the association between COVID-19 diagnosis and postoperative outcomes following bariatric surgery. METHODS: Using the Metabolic and Bariatric Surgery Accreditation Quality Improvement Project (MBSAQIP) database, patients undergoing sleeve gastrectomy and gastric bypass without a COVID-19 diagnosis were 2:1 propensity-score matched to those with COVID-19 infection pre or postoperatively. RESULTS: 1369 (0.74 ​%) and 1331 (0...

PURPOSE: In recent years, the need for revisional bariatric surgery (RBS) procedures has experienced a noteworthy surge to confront complexities and weight recidivism. Despite being a subject of controversy for many, the utilization of the Da Vinci robotic platform (Intuitive Surgical, Inc.) may present benefits in RBS. This study aimed to evaluate the outcomes of robotic RBS in comparison to Laparoscopic RBS. METHODS: A meticulous and thorough analysis was ensured through a comprehensive exploration of the literature, which included PubMed, Medline, Scopus, and Cochrane...

BACKGROUND: Obesity is a long-standing health issue in Saudi Arabia, known to be associated with various complications. The management of obesity encompasses both non-surgical and surgical interventions, such as sleeve gastrectomy. Although sleeve gastrectomy is one of the effective options for individuals with morbid obesity, it is not without potential complications. This study aims to examine the outcomes of patients who underwent laparoscopic sleeve gastrectomy. METHODS: A descriptive, retrospective study was conducted on adult patients who underwent laparoscopic sleeve gastrectomy at King Fahad General Hospital in Jeddah, Saudi Arabia, between January 2017 and July 2022...

Obesity is a global public health crisis associated with numerous medical conditions and increased mortality rates. Weight loss surgery, or bariatric surgery, has become a crucial treatment option for clinically severe obesity. Bariatric surgery is an effective treatment for severe obesity but it carries the potential for various complications, both in the short and long term. This article provides a comprehensive overview of these complications, aiding healthcare professionals in their management and patients in understanding the risks associated with bariatric surgery...

We describe gastric tube continuity restoration (gastrogastrostomy) in a patient who underwent revisional laparoscopic one-anastomosis gastric bypass (OAGB) due to weight recurrence after laparoscopic sleeve gastrectomy (SG). The patient sought restoration to SG due to poor quality of life. A postoperative 11-mm leak at the site of the gastrogastrostomy, attributed to adhesions and edema from a marginal ulcer, complicated the procedure. As a result, laparoscopic exploration was performed, followed by insertion of a megastent...

BACKGROUND: Gastric bands, specifically the Lap-Band, have been widely used for weight loss. However, little is known about the complications associated with abdominal contouring procedures in patients with Lap-Bands. This study aimed to determine the complication rates and consent processes for these procedures. METHODS: We conducted a survey study of 300 members of the American Society of Aesthetic Plastic Surgery. Commonly performed abdominal contouring procedures included abdominal liposuction, abdominoplasty, and combined abdominoplasty with abdominal liposuction...

Laparoscopic sleeve gastrectomy (LSG) is the most widely performed bariatric surgery and has been associated with excellent outcomes and a significant reduction in obesity-related morbidity and mortality. Traditionally, this surgery is performed using five to seven trocars. However, LSG performed through a single trocar is emerging as a less invasive method of performing this surgery. This systematic review and meta-analysis compare the outcomes and complication rates of single-port versus multi-port LSG. We searched PubMed, Medline, Scopus, and the Cochrane Library for articles published from 2008 to 2023, in accordance with the PRISMA 2020 guidelines...

BACKGROUND: Gastric staple line leak treatment after laparoscopic sleeve gastrectomy (LSG) remains challenging. Regenerative medicine is gaining place in the accelerated treatment of damaged tissues. This study presents the first series of gastric leak treatment after LSG using endoscopic intragastric administration of combined autologous mesenchymal stem cells (MSC) and platelet-rich plasma (PRP). METHODS: MSC-PRP harvesting and endoscopic administration techniques are described in detail...

BACKGROUND: One anastomosis gastric bypass (OAGB) is described as a simpler, potentially safe, and effective bariatric-metabolic procedure that has been recently endorsed by the American Society of Metabolic and Bariatric Surgery. OBJECTIVES: First, we aim to compare the 30-day outcomes between OAGB and other bypass procedures: Roux-en-Y gastric bypass (RYGB) and single anastomosis duodenoileal bypass with sleeve gastrectomy (SADI-S). Second, identify the odds between postoperative complications and each surgical procedure...

BACKGROUND: Adjustable gastric bands (AGB) are frequently converted to sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) due to weight recurrence or band complications. Such conversions carry a higher-risk than primary procedures. Some patients undergo two conversions-from AGB to SG, and subsequently from SG to RYGB. This presents a unique situation with limited literature on indications and complication rates associated with these double conversions. METHODS: We examined the 2020-2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Participant Use File to evaluate conversions from AGB to SG and then to RYGB...

Anastomotic leaks related to bariatric surgeries are uncommon but are related to increased morbidity and mortality. With the recent advances in intraluminal endoscopic interventions, there are some alternative options to close the leak via over-the-scope-clips/suturing or through-the-scope-clips/suturing or covered stent placement. Herein, we aimed to discuss the efficiency and the role of the through-the-scope suturing technique (X-Tack-160-H, Apollo Endosurgery, Austin, Texas, United States) in two different cases who presented with anastomotic leaks following bariatric surgery...

Introduction: Robotic bariatric surgery (RBS) has seen a surge in popularity in recent years, yet questions persist about its utility concerning postoperative complications, costs, and technical aspects. RBS, while increasing in number, presents a greater technical challenge associated with more post-operative complications compared to primary bariatric surgery. In this study, we present our single institution experience and review the literature to assess the value of robotic revisional surgery. Material and Method: The retrospective review involved 42 patients (31 females, 11 males) who underwent various procedures, with the most frequent being the conversion of sleeve gastrectomy to gastric bypass (n=30)...

BACKGROUND: One-anastomosis gastric bypass (OAGB) is an emerging metabolic bariatric surgery (MBS) type used in both primary OAGB (pOAGB) and revisional OAGB (rOAGB). We studied ≤30-day outcomes of pOAGB and rOAGB and identified predictors of early complications. METHODS: Electronic medical records of all OAGBs performed between January 2017 and December 2021 at a high-volume bariatric clinic in Israel comprising four hospital centers were scanned retrospectively using specialized data software (MDClone software, version 6...

INTRODUCTION: Achalasia following bariatric surgery is a rare phenomenon with diverse potential physiopathological origins. AIMS: This article aims to explore the hypothetical physiopathological connection between bariatric surgery and the subsequent onset of achalasia. MATERIAL AND METHODS: A review was conducted to identify studies reporting cases of peroral endoscopic myotomy (POEM) after bariatric procedures and detailing the outcomes in terms of the technical and clinical success...

BACKGROUND: Indocyanine green (ICG) is an injectable fluorochrome that has recently gained popularity as a means of assisting intraoperative visualization during laparoscopic and robotic surgery. Many systematic reviews and meta-analyses have been published. We conducted a meta-review to synthesize the findings of these studies. METHODS: PubMed and Embase were searched to identify systematic reviews and meta-analyses coping with the uses of ICG in abdominal operations, including Metabolic Bariatric Surgery, Cholecystectomy, Colorectal, Esophageal, Gastric, Hepato-Pancreato-Biliary, Obstetrics and Gynecology (OG), Pediatric Surgery, Surgical Oncology, Urology, (abdominal) Vascular Surgery, Adrenal and Splenic Surgery, and Interdisciplinary tasks, until September 2023...

In the context of adjustable gastric band (AGB) placements and the prevalent issue of weight regain with associated complications, revision surgery for gastric bands becomes imperative. Such revisions may encompass band removal or conversion to bariatric procedures, often accompanied by an escalated risk profile, potentially contributing to a 20% morbidity rate. Laparoscopic sleeve gastrectomy (LSG) has gained prominence due to its technical simplicity, effectiveness in weight loss, and lower complication rates...

BACKGROUND: Gastro-pleural and gastro-cutaneous fistulae formation are rare yet life-threatening complications post-bariatric surgery. To our knowledge so far only limited cases of gastro-pleural and gastro-cutaneous fistulae post gastric sleeve surgery have been reported in the literature with their corresponding management. Therefore, we are reporting a case of placement of an endoscopic stent in the management of gastro-cutaneous fistula post laparoscopic sleeve gastrectomy. CASE PRESENTATION: A 42 years old Pakistani, female morbidly obese patient, underwent laparoscopic sleeve gastrectomy...

PURPOSE: A revisional bariatric surgery (RBS) is necessary in about 28% of the patients. The role of robotic surgery in RBS is still a subject of debate. We aim to report the outcomes of robotic-assisted RBS at our institution. MATERIALS AND METHODS: We identified patients who underwent robotic-assisted RBSs between January 1, 2016, and May 31, 2022. We analyzed patient demographics and indications for surgery. Measured outcomes included peri- and postoperative morbidity, comorbidity management, and weight loss outcomes...

Bariatric surgery, although highly effective, may lead to several surgical complications like ulceration, strictures, leaks, and fistulas. Newer endoscopic tools have emerged as safe and effective therapeutic options for these conditions. This article reviews post-bariatric surgery complications and the role of endoscopy in their management.

BACKGROUND: Natural orifice transluminal endoscopy surgery (NOTES) gastrojejunal anastomosis (GJA) with duodenal exclusion (DE) could be used as a less invasive alternative to surgical gastric bypass. The aim of this study was to compare the efficacy and safety of both methods for bariatric purpose. METHODS: This was a prospective, experimental and comparative study on 27 obese living pigs, comparing 4 groups: GJA alone (group 1, G1), GJA + DE (group 2, G2), surgical gastric bypass (group 3, G3), control group (group 4, G4)...