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Laparoscopic roux en y gastric bypass

Talal Khewater, Nathalie Yercovich, Edouard Grymonprez, Isabelle Debergh, Bruno Dillemans
BACKGROUND: Conversional bariatric surgery has relatively high rates of complications. We aimed to analyze our single-center experience with patients requiring conversional laparoscopic Roux-en-Y gastric bypass (LRYGB) following a failed primary open or laparoscopic vertical banded gastroplasty (OVBG or LVBG, respectively). METHODS: The records of patients who underwent LRYGB as a conversional procedure after VBG between November 2004 and December 2017 were reviewed...
February 12, 2019: Obesity Surgery
Christina Y Koh, Colette S Inaba, Sarath Sujatha-Bhaskar, Ninh T Nguyen
There have been limited data on the safety of laparoscopic bariatric surgery in the elderly. To compare outcomes of laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) between elderly (≥65 years) and nonelderly (18-64 years) patients. Using the 2011 to 2015 NSQIP database, we analyzed severely obese patients who underwent LRYGB or LSG. Univariate and multivariate analyses were performed to assess primary outcomes including 30-day mortality, serious morbidity, length of stay, and readmission...
October 1, 2018: American Surgeon
Michael W Love, Roosbeh Mansour, Allyson L Hale, Eric S Bour, Ihab Shenouda, Joseph A Ewing, Sean Mcdermott, John D Scott
Internal hernias are one of the most devastating late, postsurgical complications associated with laparoscopic Roux-en-Y gastric bypass (LRYGB). The objective of this study was to determine whether placement of a bioabsorbable tissue matrix in soft tissue defects after gastric bypass resulted in a lower incidence of internal hernia development. Prospective database was used to identify all patients who underwent LRYGB between January 2002 and January 2016. These patients were then retrospectively reviewed to determine the development of internal hernia...
November 1, 2018: American Surgeon
N Beghdadi, A Soprani, A Kraemer, P Bucur, C Barrat, L Genser
BACKGROUND: Severe post-operative malnutrition (SM) is a dreaded complication after gastric bypass often related to the short bowel syndrome consecutive limb length mismeasurement or intestinal resections. Patients with rapid weight loss or malnutrition can experience liver failure with cirrhosis and require liver transplantation (LT). Malnutrition can constitute a contraindication to LT since it negatively impacts on postoperative morbidity. RYGB reversal is an effective option to consider when nutritional support has failed...
February 11, 2019: Obesity Surgery
Farah Ladak, Jerry T Dang, Noah J Switzer, Valentin Mocanu, Daniel W Birch, Shahzeer Karmali
BACKGROUND: Complications arising from laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are not insignificant and can necessitate additional invasive interventions or reoperations. OBJECTIVES: In this study, we identify early complications that result in nonoperative and operative interventions after LSG and LRYGB, the timeframe within which to expect them, and factors that influence the likelihood of their occurrence. SETTING: Multi-institutional database from across North America...
January 11, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Michał Wysocki, Magdalena Szopa, Tomasz Stefura, Alicja Dudek, Grzegorz Torbicz, Natalia Gajewska, Michał Pędziwiatr, Piotr Małczak, Magdalena Pisarska, Andrzej Budzyński, Piotr Major
BACKGROUND: Few investigations have been conducted that compared blood glucose in patients with diabetes mellitus (DM2) and morbid obesity who had undergone laparoscopic sleeve gastrectomy (LSG) or gastric bypass (LRYGB). We aimed to compare the effects of these procedures using continuous glucose monitoring (CGM). METHODS: We prospectively studied patients that had qualified for LSG or LRYGB. The inclusion criteria were DM2 of ≤ 5 years, for which patients were taking oral anti-diabetic drugs, or no glucose metabolism disorder; and morbid obesity...
February 8, 2019: Obesity Surgery
Jai Prasad, Ellen Vogels, James T Dove, Craig Wood, Anthony T Petrick, David M Parker
BACKGROUND: Bariatric surgery is the most effective treatment of obesity. There are few studies evaluating long-term outcomes in elderly patients. OBJECTIVES: Our study was designed to evaluate the safety and long-term outcomes of bariatric surgery in the elderly compared with a contemporary medically managed cohort. SETTING: University hospital. METHODS: Three hundred thirty-seven patients age ≥60 who underwent a sleeve gastrectomy or Roux-en-Y gastric bypass between January 2007 and April 2017 were identified (ElderSurg) and compared with a matched cohort of medically managed elderly patients with obesity (ElderNonSurg)...
December 22, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Peter Vorwald, Rafael Mauricio Restrepo Núñez, Gabriel Salcedo Cabañas, Maria Posada González
BACKGROUND: Up to 22% of the patients, after laparoscopic Roux-en-Y gastric bypass (LRYGB) can complain about gastroesophageal reflux disease (GERD) symptoms, there is little evidence about the most effective treatment of this situation. MATERIALS AND METHOD: This video shows a laparoscopic reintervention after a LRYGB in a 42-year-old woman presenting with untreatable GERD. GERD was treated with maximum doses of PPIs with no effect on the symptoms; the patient had a 24-h pH and impedance manometry that showed an acid and non-acid reflux, and for that reason, we decided to perform a laparoscopic fundoplication...
February 6, 2019: Obesity Surgery
Y G A Brammerloo, J C Hol, C M Theunissen, B S Langenhoff
This study reviews a single institution's experience with simultaneous (redo) laparoscopic Roux-en-Y gastric bypass (LRYGB) and primary large paraesophageal hernia (PEH) repair. A retrospective review was done of all 13 patients who underwent simultaneous LRYGB and large PEH repair between February 2014 and December 2017 at our institution. All patients had a large type III or IV PEH. All patients underwent primary crural repair, without the use of a reinforcing mesh. No patients underwent additional surgery for obstruction of the gastric pouch or for symptomatic recurrence of PEH...
February 5, 2019: Obesity Surgery
Gary Ko, Andrew Smith, Scott Cassie, Boris Zevin
BACKGROUND: An incidental finding of intestinal nonrotation at the time of bariatric surgery poses the following 2 dilemmas: (1) which operation to perform, and (2) whether an appendectomy should be performed concurrently. OBJECTIVES: To review the experience of 2 Bariatric Centers of Excellence with laparoscopic sleeve gastrectomy (LSG) in patients with intestinal nonrotation, and to perform a systematic review of the literature on this topic. SETTING: Two Bariatric Centers of Excellence as designated by the Ontario Bariatric Network...
January 11, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
William W Chang, Devon N Hawkins, Joel R Brockmeyer, Byron J Faler, Samuel W Hoppe, Balakrishna M Prasad
BACKGROUND: Bariatric surgery provides sustained weight loss and improves comorbidities. However, long term data has shown that patients gradually regain weight after 1 year. Several factors have been associated with poor weight loss after bariatric surgery. OBJECTIVE: Our goal is to investigate factors associated with poor weight loss following laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). SETTING: Military academic medical center...
January 9, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Saeed Shoar, Mohammad Naderan, Nasrin Shoar, Venkat R Modukuru, Habibollah Mahmoodzadeh
BACKGROUND: Efforts continue to understand the underlying mechanism of weight loss after bariatric surgery. Taste perception has shown to be a contributing factor. However, the alteration pattern in different taste domains and among bariatric procedures has not been sufficiently investigated. OBJECTIVES: To study the alteration pattern in the perception of four taste domains after different bariatric procedures. SETTINGS: Private Research Institute, USA...
February 2, 2019: Obesity Surgery
Wesley Fox, Andrew Borgert, Cary Rasmussen, Kara Kallies, Paul Klas, Shanu Kothari
BACKGROUND: The number of patients undergoing bariatric surgery in the United States is growing. While gastric bypass surgery is an important tool in the management of obesity, it requires lifelong metabolic monitoring and medical management. Data describing compliance with recommended laboratory follow-up are limited, particularly in long-term and primary care settings. OBJECTIVES: To evaluate postoperative follow-up laboratory testing for patients after laparoscopic Roux-en-Y gastric bypass (LRYGB)...
January 9, 2019: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Kara J Kallies, Andrew J Borgert, Shanu N Kothari
As the rate of obesity continues to rise, primary care providers (PCPs) must be aware and informed of the treatment options available. Bariatric surgery is the most effective long-term treatment for weight loss and improvement of obesity-related comorbidities. The aim of this study was to assess patients' perception of their PCP's opinion, support and knowledge of bariatric surgery and changes over time. In 2009 and 2015, a 27-question survey was developed and mailed to patients who had undergone laparoscopic Roux-en-Y gastric bypass (LRYGB) at our institution...
February 1, 2019: Clinical Obesity
Marcelo Montenegro, Helena Slongo, Cassia Raquel Teatin Juliato, Vatche Arakel Minassian, Ali Tavakkoli, Luiz Gustavo Oliveira Brito
OBJECTIVE: to determine the effect of bariatric surgery (BS) on the prevalence of pelvic floor dysfunctions (PFD), specifically on urinary incontinence (UI), pelvic organ prolapse (POP) and fecal incontinence (FI) DATA SOURCES: a systematic review (PROSPERO registration CRD42017068452) with literature search was performed using PubMed, Scopus and Scielo databases for all publications related to BS and PFD, with no language restrictions from inception to September 2018. METHODS OF STUDY SELECTION: two authors screened for study eligibility and extracted data...
January 29, 2019: Journal of Minimally Invasive Gynecology
Mohamad A Minhem, Bassem Y Safadi, Hani Tamim, Aurelie Mailhac, Ramzi S Alami
BACKGROUND: Intraoperative endoscopy (IOE) has been proposed to decrease serious complications following bariatric surgeries such as leaks, bleeding, and stenosis. Such complications can lead to sepsis and eventually can be fatal. We aim to compare major postoperative complications in patients with and without IOE. METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program database years 2011 till 2016 were used to identify laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB) patients...
January 31, 2019: Surgical Endoscopy
Alejandro Brañes, Matias Orellana, Rodrigo Muñoz
INTRODUCTION: Venous thromboembolism (VTE) in bariatric surgery is a low incidence disease; however, it is the first cause of morbimortality in this group of patients. PRESENTATION OF THE CASE: We present the case of a female patient with morbid obesity who was readmitted due to an acute submassive bilateral pulmonary embolism (PE) nineteen days after a laparoscopic Roux-en-Y gastric bypass (RYGB). After diagnosis, anticoagulation was initiated, and decision to add mechanical and pharmacological thrombolysis was made with the patient been successfully treated, as shown by normalization of pulmonary hypertension...
January 19, 2019: International Journal of Surgery Case Reports
Areli Valencia, Luis C Garcia, John Morton
BACKGROUND: Previous studies have demonstrated that ethnic minority patients experience significant metabolic improvements after bariatric surgery but less so than non-Hispanic whites. Previous research has primarily investigated differences between non-Hispanic white and black patients. Thus, there remains a need to assess differences in diabetic outcomes among other ethnic groups, including Hispanic and Asian patient populations. MATERIALS AND METHODS: A retrospective analysis including 650 patients with type II diabetes mellitus (T2DM), who underwent either laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy (LSG) procedures, was conducted to understand ethnic disparities in diabetic metabolic outcomes, including weight loss, serum concentrations of glucose, fasting insulin, and hemoglobin A1c (HbA1c)...
January 4, 2019: Journal of Surgical Research
Emanuele Rausa, Michael E Kelly, Elisa Galfrascoli, Albero Aiolfi, Federica Cavalcoli, Luca Turati, Luigi Bonavina, Giovanni Sgroi
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common bariatric operations performed worldwide. Quality of life (QoL) is a crucial outcome metric. An electronic systematic search using PubMed, EMBASE, and Web of Science of studies comparing QoL after LSG and LRYGB was performed. QoL after both LSG and LRYGB considerably improves regardless the type of surgery. The QoL has a slight downward trend from the second to the fifth year postoperatively, but it remains higher than the baseline...
January 29, 2019: Obesity Surgery
Elisabeth K Wynne, Dan E Azagury
BACKGROUND: Undetected bowel perforations occur in 0.3-1% of laparoscopic surgical procedures with an associated mortality rate of 5.3%. OBJECTIVE: The purpose of the study was to evaluate the clinical feasibility of a novel medical device to accurately detect bowel gas, specifically hydrogen (H2 ) and methane (CH4 ), from a sample of gas from the abdominal cavity during laparoscopic surgery when a known bowel wall perforation has occurred. SETTING: University (Academic) Hospital...
January 28, 2019: Surgical Endoscopy
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