427 results on '"Banded gastroplasty"'
Search Results
2. Endoscopic revision for weight regain after open vertical-banded gastroplasty
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Piero Giustacchini, Milutin Bulajic, Guido Costamagna, Salvatore Francesco Vadala' di Prampero, and Gabriella Manzoni
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medicine.medical_specialty ,Weight regain ,business.industry ,RYGB, Roux-en-Y gastric bypass ,Gastroenterology ,Medicine ,Radiology, Nuclear Medicine and imaging ,VBG, vertical-banded gastroplasty ,business ,Video Case Report ,OVBG, open vertical-banded gastroplasty ,Banded gastroplasty ,Surgery - Abstract
Video Video 1 Technical feasibility, safety, and efficacy of a novel endoscopic approach to treating weight regain after open vertical-banded gastroplasty using an endoscopic suturing device.
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- 2021
Catalog
3. Remission and progression of pre-existing micro- and macroalbuminuria over 15 years after bariatric surgery in Swedish Obese Subjects study
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C. W. le Roux, C D Sjöström, Kajsa Sjöholm, Magdalena Taube, Lena M. S. Carlsson, A. Shulman, P-A Svensson, Johanna C. Andersson-Assarsson, Markku Peltonen, and Peter Jacobson
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Adult ,Male ,medicine.medical_specialty ,Urinary albumin ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Medicine (miscellaneous) ,Bariatric Surgery ,030209 endocrinology & metabolism ,Disease ,urologic and male genital diseases ,Article ,03 medical and health sciences ,0302 clinical medicine ,Medicine ,Albuminuria ,Humans ,030212 general & internal medicine ,Obesity ,Sweden ,Nutrition and Dietetics ,business.industry ,Incidence (epidemiology) ,Incidence ,Middle Aged ,medicine.disease ,female genital diseases and pregnancy complications ,Surgery ,Banded gastroplasty ,Treatment Outcome ,Disease Progression ,Kidney Failure, Chronic ,Microalbuminuria ,Obese subjects ,Female ,medicine.symptom ,business - Abstract
Bariatric surgery reduces incidence of albuminuria and end-stage renal disease in patients with obesity. Effects of bariatric surgery on long-term remission and progression of pre-existing obesity-related renal damage are mainly unexplored. Here we investigate the long-term effects of bariatric surgery compared with conventional obesity care on remission and progression of albuminuria. 4047 patients were included in the Swedish Obese Subjects study. Inclusion criteria were age 37–60 years, BMI ≥ 34 kg/m2 in men and BMI ≥ 38 kg/m2 in women. Our analysis comprised 803 patients (19.8% of total population, 357 control, 446 surgery) with pre-existing albuminuria including 693 patients (312 control, 381 surgery) with microalbuminuria, and 110 patients (45 control, 65 surgery) with macroalbuminuria. Surgery patients were treated with banding, vertical banded gastroplasty, or gastric bypass. Control patients received conventional obesity care. Total urinary albumin excretion was 36.5% lower in all patients with albuminuria after 15 years, 44.5% lower in patients with microalbuminuria after 15 years, and 27.8% lower in patients with macroalbuminuria after 2 years following bariatric surgery compared with conventional care. In surgery patients with microalbuminuria, remission to normoalbuminuria was higher (OR, 5.9, 2.2, 3.2, p more...
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- 2020
4. Primary Roux-en-Y Gastric Bypass Results in Greater Weight Loss at 15-Year Follow-Up Compared with Secondary Roux-en-Y Gastric Bypass After Failure of Gastric Band or Mason McLean Vertical Gastroplasty
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Antonio Iannelli, Anne-Sophie Schneck, Jean Gugenheim, Jean Hubert Etienne, Mailys Goetschy, and Niccolò Petrucciani
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medicine.medical_specialty ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,Gastric bypass ,Gastric Bypass ,030209 endocrinology & metabolism ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Internal medicine ,Weight Loss ,medicine ,Humans ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,bariatric surgery ,complications ,long-term results ,obesity ,primary ,roux-en-y gastric bypass ,secondary ,weight loss ,Reflux ,nutritional and metabolic diseases ,medicine.disease ,Roux-en-Y anastomosis ,Obesity, Morbid ,Banded gastroplasty ,Gastric band ,Treatment Outcome ,Propensity score matching ,Quality of Life ,GERD ,030211 gastroenterology & hepatology ,Surgery ,medicine.symptom ,business ,Follow-Up Studies - Abstract
The aim of the study is to compare the outcomes of patients treated with secondary Roux-en-Y gastric bypass (RYGB) after adjustable gastric banding (AGB) or vertical banded gastroplasty (VBG) with those of patients having primary RYGB.Patients undergoing secondary RYGB after AGB or VBG between 1997 and 2004 with a minimal follow-up of 15 years were matched using a propensity score (according to gender, age, BMI, duration of follow-up) with comparable patients who underwent primary RYGB.The mean follow-up was 16.50 years in the secondary RYGB group (N = 32) versus 16.33 years in the primary RYGB group (N = 32). Early postoperative complications rate was 6.25% in the secondary RYGBs versus 9.38% in the primary RYGBs (P = 1). Late postoperative complications and additional surgical procedures were 56.25% and 37.5% in the secondary and primary RYGB group, respectively (P = 0.21). Long-term (at 16-20 years) %TWL and %EWL were significantly lower (P 0.01 and P = 0.013, respectively) after secondary RYGB (%TWL = 7.56%; %EWL = 17.15%) than after primary RYGB (%TWL = 24.51%; %EWL = 55.61%). Remission of obesity-related comorbidities was comparable (P 0.05). Gastroesophageal reflux was more frequent after secondary RGYB-43.75% versus 25%, P 0.05. Quality of life-Morehead-Ardelt II score (0.02 in secondary RYGB versus 0.69 in primary RYGB, P = 0.13), general self-assessment of health status and weight satisfaction were comparable.Secondary RYGB after AGB or VBG is less efficient at weight loss, GERD remission and energy expenditure at 15 years after conversion. However, it is as effective for improvement/resolution of obesity-related comorbidities and is associated with similar QoL scores. more...
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- 2020
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5. Comparison of Surgical Activity and Scientific Publications in Bariatric Surgery: an Epidemiological and Bibliometric Analysis
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S. Epaud, Luca Paolino, M. Ortala, Andrea Lazzati, and R. Pravettoni
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medicine.medical_specialty ,Sleeve gastrectomy ,Asia ,Bibliometric analysis ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric Bypass ,Psychological intervention ,Bariatric Surgery ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Weight Loss ,Epidemiology ,medicine ,Humans ,National level ,Nutrition and Dietetics ,business.industry ,Scientific production ,medicine.disease ,Obesity ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,Europe ,Latin America ,Bibliometrics ,030211 gastroenterology & hepatology ,business - Abstract
In the last two decades, an impressive increase in the number of surgical interventions was recorded in bariatric surgery. Similarly, several bibliometric studies reported an increasing trend for scientific production. This study aims to compare these two trends. This study focused on the period 2003–2016 and included the following procedures: adjustable gastric banding (AGB), bilio-pancreatic deviation (BPD), one-anastomosis gastric bypass (OAGB), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and vertical banded gastroplasty (VBG). We retrieved the data on intervention from International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) surveys and data from publications from the Web of Science database. An analysis of the global trend and the trend per continent was performed. Over the study period, the most common procedure to be performed was RYGB (47.1%) followed by SG (33.5%) and AGB (14.8%). The percentage of publications was similar, with 48.3% studies on RYGB, 18.5% on AGB, and 18.4% on SG. In terms of evolution, SG has become the most common procedure to be performed in every continent but Latin America, while RYGB remains the most frequently discussed in scientific publications. Asia has the highest rate of publications per 1000 interventions (4.7), followed by Europe (3.0), the Pacific (2.0), and North America (1.6). This study found many similarities in the trend of publications and interventions in bariatric surgery: in particular with an important growth rate in the last 15 years and the progressive polarization toward two procedures (SG and RYGB). Nevertheless some important differences persist at a national level. more...
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- 2020
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6. Vertical Banded Gastroplasty Revision to Gastric Bypass Leads to Effective Weight Loss and Comorbidity and Dysphagia Symptom Resolution
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Dimitrios Stefanidis, Sara Monfared, Ambar Banerjee, Jennifer N. Choi, Dimitrios I. Athanasiadis, and Don J. Selzer
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medicine.medical_specialty ,Sleeve gastrectomy ,Nutrition and Dietetics ,business.industry ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric bypass ,030209 endocrinology & metabolism ,medicine.disease ,Comorbidity ,Dysphagia ,Surgery ,Banded gastroplasty ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Cohort ,Medicine ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Complication - Abstract
Up to 50% of patients with vertical banded gastroplasty (VBG) experience failure or complications in the mid- and long-term and present for revisional bariatric surgery. This study aimed to review our experience for patient outcomes after VBG revisions and compare their benefits to those of primary laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Data from patients who underwent VBG revision between 2009 and 2015 at a center of excellence were reviewed. Patient demographics, symptoms, comorbidities, weight loss, reinterventions, reoperations, and hospital stay were analyzed and compared with those of primary LRYGB patients (control group). Fifty-two patients (88.5% female, 55 ± 9.6 years old) underwent revisional surgery during the study period (86.5% LRYGB, 11.5% VBG reversal, and 2% sleeve gastrectomy). Patients presented 17.3 ± 7.2 years after their VBG for weight regain (55.8%), dysphagia (19.2%), or both (25%). Patients who underwent conversion to LRYGB for weight regain and for mix-symptoms had similar weight loss to the control group (38.2 ± 11.8 vs 35.6 ± 7.7, p = 0.108), along with similar comorbidity resolution. However, even though the early ( more...
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- 2020
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7. Management of surgical complications of previous bariatric surgery in pregnant women. A systematic review from the BARIA-MAT Study Group
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Ciangura, Cecile, Debs, Tarek, Coupaye, Muriel, Deruelle, Philippe, Gascoin, Geraldine, Calabrese, Daniela, Cosson, Emmanuel, Ducarme, Guillaume, Gaborit, Benedicte, Lelievre, Benedicte, Mandelbrot, Laurent, Petrucciani, Niccolo, Quilhot, Didier, Ritz, Patrick, Robin, Geoffroy, Sallé, Agnès, Gugenheim, Jean, Nizard, Jacky, Castera, Virginie, Coutant, Regis, Dupré, Thierry, Johanet, Hubert, Pigeyre, Marie, Rochereau, Brigitte, Taillard, Véronique, Canale, Claudine, Joly, Anne-Sophie, Centre Hospitalier Universitaire de Nice (CHU Nice), Centre recherche en CardioVasculaire et Nutrition = Center for CardioVascular and Nutrition research (C2VN), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Hôpital Nord [CHU - APHM], Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), and Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] more...
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[SDV]Life Sciences [q-bio] ,medicine.medical_treatment ,Bariatric Surgery ,0302 clinical medicine ,OBESE-PATIENTS ,Pregnancy ,Sleeve gastrectomy ,education.field_of_study ,medicine.diagnostic_test ,SMALL-BOWEL OBSTRUCTION ,ariatric surgery ,emergency ,gastric banding ,gastric bypass ,pregnancy ,sleeve gastrectomy ,surgery ,Obesity, Morbid ,3. Good health ,MATERNAL OVERWEIGHT ,Female ,030211 gastroenterology & hepatology ,Presentation (obstetrics) ,Gastric banding ,Internal hernia ,medicine.medical_specialty ,Gastroplasty ,NEONATAL OUTCOMES ,Gastric bypass ,Population ,Gastric Bypass ,030209 endocrinology & metabolism ,GASTRIC BYPASS-SURGERY ,PATIENT ,INTERNAL HERNIA ,DIFFERENTIAL METHYLATION ,03 medical and health sciences ,medicine ,Humans ,education ,business.industry ,Magnetic resonance imaging ,medicine.disease ,Surgery ,Banded gastroplasty ,Emergency ,Laparoscopy ,WEIGHT ,Pregnant Women ,FOLLOW-UP ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; Considering the large and increasing population of women of childbearing age with history of bariatric surgery, surgical complications of bariatric surgery during pregnancy may become more frequent in the future. The aim of this study was to analyze the clinical presentation, diagnostic procedures, and treatment of surgical complications of bariatric surgery during pregnancies. A systematic literature search was performed in accordance with the PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines to identify all studies published up to and including December 2018 that included women with previous bariatric surgery undergoing emergency surgery during pregnancy. Sixty-eight studies were selected, including 120 women with previous bariatric surgery undergoing emergency surgery during pregnancy. Fifty cases were reported as case reports and 70 in case series. Included patients had previous history of Roux-en-Y gastric bypass (n = 99), laparoscopic adjustable gastric banding (n = 17), Scopinaro procedure (n = 2), vertical banded gastroplasty (n = 1), or one-anastomosis gastric bypass (n = 1). Final diagnosis in 50 case reports was internal hernia in 26 cases, bowel intussusception in 10, intestinal obstruction in 2, laparoscopic adjustable gastric banding slippage in 3, bowel volvulus in 3, gastric or jejunal perforation in 2, and other complications in 4 cases. Maternal and fetal death occurred in 3 (2.5%) and 9 cases (7.5%), respectively. In the case series, the majority of women were operated for internal hernia and laparoscopic adjustable gastric banding slippage. Surgical complications of previous bariatric surgery during pregnancy have potentially severe outcomes. Availability of multidisciplinary expertise, including bariatric/digestive surgeons, and education of healthcare providers and women on clinical signs that require urgent surgical examination are recommended in this setting. Prompt diagnosis is fundamental and based on clinical and laboratory findings and on radiologic examinations if needed, including computed tomography scan or magnetic resonance if available. Rapid surgical exploration is mandatory in case of high clinical and/or radiologic suspicion. (C) 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved. more...
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- 2020
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8. Laparoscopic revision of vertical banded gastroplasty with gastrogastric fistula to sleeve gastrectomy
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Selim Sözen, Serkan Bayil, Hasan Erdem, and Mehmet Gençtürk
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medicine.medical_specialty ,Sleeve gastrectomy ,business.industry ,medicine.medical_treatment ,food and beverages ,Vertikal gastroplasti,gastrogastrik fistül,sleeve gastrektomi ,General Medicine ,Gastrogastric fistula ,Surgery ,Banded gastroplasty ,Vertical banded gastroplasty surgery ,Medicine ,vertical gastroplasty,gastrogastric fistula,sleeve gastrectomy ,In patient ,business ,Cerrahi - Abstract
Gastrogastric fistula is one of the complications that can occur after vertical banded gastroplasty surgery for weight loss. Sleeve gastrectomy can be performed successfully in patients with gastrogastric fistula in revision surgery. In this study, we present current treatment for the complication of vertical banded gastroplasty (Mason procedure). Revision of vertical banded gastroplasty to sleeve gastrectomy is a safe and feasible option for patients presenting with gastrogastric fistula., Gastrogastrik fistül, kilo kaybı için yapılan vertikal band gastroplasti ameliyatından sonra ortaya çıkabilecek komplikasyonlardan biridir. Revizyon cerrahisinde gastrogastrik fistülü olan hastalarda sleeve gastrektomi başarıyla yapılabilir. Bu çalışmada, vertikal band gastroplasti (Mason prosedürü) komplikasyonu için güncel tedaviyi sunuyoruz. Gastrogastrik fistül ile başvuran vertikal band gastroplastinin, sleeve gastrektomiye revizyonu güvenli ve uygulanabilir bir seçenektir. more...
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- 2020
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9. ONE ANASTOMOSIS GASTRIC BYPASS AS A SALVAGE MANAGEMENT FOR WEIGHT REGAIN AFTER VERTICAL BANDED GASTROPLASTY; SINGLE INSTITUTE EXPERIENCE
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Mohamed Ibrahim
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medicine.medical_specialty ,Weight regain ,business.industry ,Gastric bypass ,medicine ,Anastomosis ,business ,Surgery ,Banded gastroplasty - Published
- 2019
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10. Robotic Roux-en-Y Gastric Bypass as a Revisional Bariatric Procedure: a Single-Center Prospective Cohort Study
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Fabrizio Rebecchi, Mauro Toppino, Alessandro Borello, Mario Morino, Marco E. Allaix, and Elettra Ugliono
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Adult ,Male ,Reoperation ,Sleeve gastrectomy ,medicine.medical_specialty ,Databases, Factual ,Gastroplasty ,Robot ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Gastric bypass ,Gastric Bypass ,Anastomotic Leak ,030209 endocrinology & metabolism ,Single Center ,Revisional bariatric surgery ,RYGB ,Cohort Studies ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Gastrectomy ,Weight loss ,Weight Loss ,Humans ,Medicine ,Prospective Studies ,Prospective cohort study ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Mortality rate ,Middle Aged ,Conversion to Open Surgery ,Roux-en-Y anastomosis ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Roux-en-Y gastric bypass (RYGB) is the procedure of choice to manage the failure of primary bariatric surgery. However, the current evidence on the role of the robotic technology in revisional bariatric surgery is very limited. The aim of this study is to report safety and effectiveness of revisional RYGB performed with the DaVinci Robotic Surgical System (R-rRYGB) after failed primary bariatric surgery. Clinical data of consecutive patients undergoing R-rRYGB were included in a prospectively collected database. Intraoperative findings, early postoperative outcomes, and 1-year follow-up results were considered. Primary outcome was postoperative morbidity rate. Secondary outcomes were conversion to open surgery, length of stay, percentage of excess weight loss (%EWL), resolution of complications, and costs. A total of 68 patients underwent R-rRYGB at our department from 2011 to 2016. Primary procedures were laparoscopic adjustable gastric banding (n = 10), vertical banded gastroplasty (n = 43), and sleeve gastrectomy (n = 15). Conversion rate to open surgery was 2.9%. Postoperative morbidity rate was 8.8%, with no anastomotic leaks reported. Total cost for surgical procedure was 14,334.7 ± 2920.4 €. Revisional RYGB is a complex procedure but can be performed with the robotic approach with a low morbidity rate. Weight loss outcomes and resolution of complications of the index procedure are satisfactory. more...
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- 2019
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11. Twelve-Year Experience with Roux-en-Y Gastric Bypass as a Conversional Procedure for Vertical Banded Gastroplasty: Are We on the Right Track?
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Jan Paul Mulier, Edouard Grymonprez, Nathalie Yercovich, Talal Khewater, Julie Horevoets, and Bruno Dillemans
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Adolescent ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,Gastric bypass ,Gastric Bypass ,030209 endocrinology & metabolism ,Body Mass Index ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Patient satisfaction ,Quality of life ,Weight loss ,Weight Loss ,Humans ,Medicine ,Obesity ,Aged ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Complete remission ,nutritional and metabolic diseases ,Middle Aged ,Roux-en-Y anastomosis ,Obesity, Morbid ,Surgery ,Banded gastroplasty ,Patient Satisfaction ,Quality of Life ,Female ,030211 gastroenterology & hepatology ,Morbidity ,medicine.symptom ,business ,Body mass index - Abstract
Vertical banded gastroplasty (VBG) has high rates of long-term complications. Conversion to Roux-en-Y gastric bypass (RYGB) is considered optimal; however, there are limited data on the late results of these conversions. We aimed to analyze our single-center long-term outcomes of patients requiring conversional RYGB for a failed VBG. The records of patients who underwent RYGB as a conversional procedure after VBG from November 2004 to December 2016 were reviewed. Follow-up data were obtained by direct telephone calls with patients, electronic files, and general practitioner reports. Characteristics, indications of conversion, long-term (> 30 days) morbidities, weight records, obesity-related comorbidities, and overall patient satisfaction were analyzed. Overall, 305 VBG patients (82% female) underwent conversional RYGB during the study period. The mean pre-RYGB body mass index (BMI) was 35.6 (23–66) kg/m2. Conversions were indicated in 61% of patients because of simultaneous VBG complications and weight regain. After a median follow-up of 74.3 (5–151) months, 225 (73.8%) patients agreed to participate. The mean BMI and percentage of total weight loss (%TWL) were 28.6 (18–45) kg/m2 and 17.4%, respectively. Nearly all conversion indications were addressed effectively. Surgical reintervention was mandatory in 28 of 225 patients (12.4%) due to complications. Approximately 85% of patients reported complete remission of obesity-related comorbidities, and four-fifths were fully satisfied. RYGB resolves VBG complications, improves quality of life, and results in prolonged stable weight loss. It has a key role in the management of obesity-related comorbidities and in expert hands is the preferred conversional procedure for patients with failed VBG. more...
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- 2019
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12. Conversion of both Versions of Vertical Banded Gastroplasty to Laparoscopic Roux-en-Y Gastric Bypass: Analysis of Short-term Outcomes
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Bruno Dillemans, Edouard Grymonprez, Nathalie Yercovich, Isabelle Debergh, and Talal Khewater
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,Gastric bypass ,Gastric Bypass ,Length of hospitalization ,030209 endocrinology & metabolism ,Conversion to open surgery ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Weight Loss ,medicine ,Humans ,Aged ,High rate ,Nutrition and Dietetics ,business.industry ,Middle Aged ,Conversion to Open Surgery ,Roux-en-Y anastomosis ,Early complication ,Obesity, Morbid ,Surgery ,Banded gastroplasty ,Treatment Outcome ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,business ,Body mass index - Abstract
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). The records of patients who underwent LRYGB as a conversional procedure after VBG between November 2004 and December 2017 were reviewed. Characteristics, body mass index (BMI), operation time, intraoperative problems, length of hospitalization, and early ( more...
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- 2019
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13. Use of a Lumen-Apposing Metal Stent for Management of Pouch Outlet Stenosis After Vertical Banded Gastroplasty
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Maurice Marcuard, Lindsey B Cundra, and Parth J. Parekh
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stent ,Lumen (anatomy) ,Surgical Revision ,Case Report ,Endoscopy ,General Medicine ,Anastomosis ,medicine.disease ,Banded gastroplasty ,Surgery ,Stenosis ,medicine ,Pouch ,business - Abstract
Lumen-apposing metal stents (LAMSs) offer a novel alternative for the treatment of anastomotic strictures or short, benign gastrointestinal strictures. In the bariatric realm, LAMSs provide a potentially safer, efficacious, and nonsurgical approach to surgical revision. Here, we present a case where a LAMS was successfully used to manage pouch outlet stenosis from a previous vertical banded gastroplasty. more...
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- 2021
14. Comment on: Revision of vertical banded gastroplasty to Roux-en-Y gastric bypass with fundectomy
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Enrico Facchiano
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medicine.medical_specialty ,Gastroplasty ,business.industry ,Gastric bypass ,Gastric Bypass ,Anastomosis, Roux-en-Y ,Anastomosis ,Roux-en-Y anastomosis ,Banded gastroplasty ,Surgery ,Obesity, Morbid ,Weight loss ,Weight Loss ,medicine ,Humans ,medicine.symptom ,business - Published
- 2021
15. Roux-en-Y gastric bypass versus one anastomosis-mini gastric bypass as a rescue procedure following failed restrictive bariatric surgery. A systematic review of literature with metanalysis
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Mario Musella, Nunzio Velotti, Antonio Vitiello, Giovanna Berardi, Katia Di Lauro, Velotti, Nunzio, Vitiello, Antonio, Berardi, Giovanna, Di Lauro, Katia, and Musella, Mario
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Reoperation ,medicine.medical_specialty ,Roux-en-Y gastric bypass (RYGB) ,Gastric bypass ,Revisional surgery ,Gastric Bypass ,One anastomosis-mini gastric bypass (OAGB-MGB) ,Anastomosis ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,medicine ,Humans ,Adjustable gastric band ,Retrospective Studies ,Bariatric surgery ,Mini gastric bypass ,business.industry ,Perioperative ,Roux-en-Y anastomosis ,Obesity, Morbid ,Surgery ,Banded gastroplasty ,Treatment Outcome ,030220 oncology & carcinogenesis ,Laparoscopy ,030211 gastroenterology & hepatology ,business ,Body mass index - Abstract
Background Although different procedures have been proposed as revisional surgery for patients who had previously undergone a failed primary restrictive procedure, the ideal revisional procedure is still a matter of debate. Methods A systematic search was performed in all electronic databases to find studies comparing one anastomosis-mini gastric bypass (OAGB-MGB) or Roux-en-Y gastric bypass (RYGB) as revisional bariatric surgery for weight regain or intolerance/complications of a primary restrictive procedure. The data regarding sample size, patients’ gender, age, primary surgery type, number of perioperative complications, operative time, pre- and post-revisional body mass index (BMI), and excess weight loss % (EWL%) at 1-year follow-up were extracted. Five studies were included in the analysis. Results The primary bariatric procedures were represented by vertical banded gastroplasty (VBG), laparoscopic adjustable gastric band (LAGB) and laparoscopic sleeve gastrectomy (LSG). About perioperative complications, both RYGB and OAGB-MGB showed a similar rate of leaks but OAGB-MGB had a lower rate of bleedings; considering the progression from pre- to post-revisional BMI, OAGB-MGB reveals a better outcome as well as a shorter operative time. Conclusions Our meta-analysis has shown OAGB-MGB, used as revisional intervention after failed restrictive surgery, achieves outcomes comparable to RYGB in terms of perioperative complications providing a simpler and more effective technique. more...
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- 2021
16. Revision of Mason's procedure (vertical banded gastroplasty) to Roux-en-Y gastric bypass: role of an associated fundectomy in weight loss outcomes
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Claire Chalumeau, Emmanuel Disse, Maud Robert, Axel Denneval, Elise Pelascini, Sylvain Iceta, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Centre Hospitalier Chalon-sur-Saône William Morey, Institut Universitaire de Cardiologie et de Pneumologie de Québec (IUCPQ), Université Laval [Québec] (ULaval), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Laval University Medical center, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Université de Lyon-Université de Lyon-Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), and CarMeN, laboratoire more...
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Reoperation ,medicine.medical_specialty ,Gastroplasty ,[SDV]Life Sciences [q-bio] ,Gastric bypass ,Revisional surgery ,Gastric Bypass ,030209 endocrinology & metabolism ,Body Mass Index ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,Vbg ,Weight Loss ,Medicine ,Humans ,VBG to RYGB conversion ,Retrospective Studies ,business.industry ,Retrospective cohort study ,Odds ratio ,Mason ,Roux-en-Y anastomosis ,3. Good health ,Banded gastroplasty ,Surgery ,Obesity, Morbid ,[SDV] Life Sciences [q-bio] ,Treatment Outcome ,030211 gastroenterology & hepatology ,Fundectomy ,Laparoscopy ,medicine.symptom ,Complication ,business ,Body mass index - Abstract
International audience; BACKGROUND: Vertical banded gastroplasty (VBG) presents a significant rate of long-term complications, and revisions are often necessary. Conversion to Roux-en-Y gastric bypass (RYGB) seems to be preferred, but literature data remain limited. OBJECTIVES: To analyze the indications, safety, results of conversions from VBG to RYGB, and to identify predictive factors of success or failure. SETTING: Two specialized centers of bariatric surgery. METHODS: This bicentric retrospective study included all the patients who benefited from a conversion from VBG to RYGB between 2008 and January 2020. Demographic characteristics, indications, preoperative workups, intraoperative data, complications, and weight loss results were analyzed. RESULTS: During the study period, 85 patients underwent a conversion to RYGB. The mean body mass index (BMI_ before conversion was 40.6 kg/m(2). 82.3% of the patients were converted because of weight loss failure and 17.6% because of a complication of their VBG. The global rate of complications was 25%. After an average follow-up of 35 months and a rate of loss to follow-up of 33%, the mean BMI was 33.5 kg/m. The weight loss success rate according to Reinhold's criteria was 64.7%, and resolution of complications was obtained in 89.1%. The association of a fundectomy was a predictive factor of weight loss (odds ratio, .27; P = .04), whereas primary failure of the VBG was a predictive factor of failure. CONCLUSION: Conversion from VBG to RYGB remains the procedure of choice to achieve satisfying weight loss and resolution of functional complications. The addition of a fundectomy appeared to have a significant positive impact on weight loss outcomes. more...
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- 2020
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17. From the Knife to the Endoscope-a History of Bariatric Surgery
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Agrawal S, M S Majid, and T Wiggins
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0301 basic medicine ,Sleeve gastrectomy ,medicine.medical_specialty ,Endoscope ,Gastroplasty ,Gastric banding ,medicine.medical_treatment ,Gastric bypass ,Gastric Bypass ,Bariatric Surgery ,030209 endocrinology & metabolism ,History, 21st Century ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,medicine ,Humans ,Endoscopy, Digestive System ,Laparoscopy ,Biliopancreatic Diversion ,030109 nutrition & dietetics ,medicine.diagnostic_test ,business.industry ,General Medicine ,History, 20th Century ,Duodenal switch ,Surgery ,Banded gastroplasty ,Obesity, Morbid ,Treatment Outcome ,business - Abstract
Current bariatric surgical practice has developed from early procedures, some of which are no longer routinely performed. This review highlights how surgical practice in this area has developed over time. This review outlines early procedures including jejuno-colic and jejuno-ileal bypass, initial experience with gastric bypass, vertical banded gastroplasty and biliopancreatic diversion with or without duodenal switch. The role laparoscopy has played in the widespread utilization of surgery for treatment of obesity will be described, as will the development of procedures which form the mainstay of current bariatric surgical practice including gastric bypass, sleeve gastrectomy and adjustable gastric banding. Endoscopic therapies for the treatment of obesity will be described. By outlining how bariatric surgical practice has developed over time, this review will help practicing surgeons understand how individual procedures have evolved and also provide insight into potential future developments in this field. more...
- Published
- 2020
18. Complications of Restrictive Procedures
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Mirto Foletto, Alice Albanese, and Luca Prevedello
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Sleeve gastrectomy ,medicine.medical_specialty ,business.industry ,Gastric banding ,medicine.medical_treatment ,Limiting ,Upper gastrointestinal endoscopy ,Banded gastroplasty ,Surgery ,Calorie intake ,Weight loss ,medicine ,medicine.symptom ,business - Abstract
Bariatric restrictive procedures induce weight loss by limiting food and calorie intake. This group of procedures is heterogeneous as far as the surgical technique. The consequent anatomical modifications may cause different potential complications. The complications of restrictive procedures need to be properly recognized and addressed, given the high number of patients treated in the past that may require conversion from previous bariatric procedures (vertical banded gastroplasty or gastric banding) or the increasing number of patients subjected to sleeve gastrectomy worldwide. Thorough reassessment via upper gastrointestinal endoscopy and contrast series are the mainstays to approach surgical complications and plan conversion surgery. more...
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- 2020
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19. Food Tolerance and Quality of Alimentation Following Laparoscopic Sleeve Gastrectomy Calibrated with a 50-Fr Bougie: Long-Term Results
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Maryana Bozhychko, Jone Miren Del-Campo, Jaime Ruiz-Tovar, Carolina Llavero, and Lorea Zubiaga
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Adult ,Male ,Sleeve gastrectomy ,medicine.medical_specialty ,Gastric banding ,medicine.medical_treatment ,Bariatric Surgery ,030209 endocrinology & metabolism ,Diet, Mediterranean ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Surveys and Questionnaires ,Weight Loss ,medicine ,Humans ,Postoperative Period ,Prospective Studies ,Aged ,Laparoscopic sleeve gastrectomy ,business.industry ,digestive, oral, and skin physiology ,Feeding Behavior ,Long term results ,Middle Aged ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,Treatment Outcome ,Patient Satisfaction ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,business ,Follow-Up Studies - Abstract
Adjustable gastric banding and vertical banded gastroplasty are associated with the worst postoperative food tolerance of all bariatric techniques. However, food tolerance tends to improve over time. The aim of this study was to assess food tolerance and diet quality in patients undergoing a sleeve gastrectomy, 1 and 5 years after surgery.A prospective observational study of all the morbidly obese patients undergoing laparoscopic sleeve gastrectomy was performed. Food tolerance was assessed using the Quality of Alimentation questionnaire validated in bariatric patients.Ninety-three patients were analyzed. One year after surgery, mean excess weight loss (EWL) was 81.1% ± 8.3%, and 5 years after surgery, mean EWL was 79.9% ± 6.4%. Preoperatively, 39.8% of patients perceived their eating patterns as good or excellent, 1 year after surgery, 79.6% and 5 years postoperatively, 86%. One year after surgery, the patients reported some difficulty in tolerance of rice, pasta, and red meat. Five years after surgery, these difficulties disappeared and very few patients just refer some tolerance difficulties with red meat. One year after surgery, 10% of the patients reported that they suffered postprandial vomiting often and 22% rarely. Five years postoperatively, only 8% of subjects describe rarely vomiting.After sleeve gastrectomy, the patients recognize an improvement in the quality of alimentation. During the first postoperative year, they present tolerance problems with rice, pasta, and red meat, and that disappeared 5 years after surgery. more...
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- 2018
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20. Perioperative Outcomes of Laparoscopic and Robotic Revisional Bariatric Surgery in a Complex Patient Population
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Rasa Zarnegar, Cheguevara Afaneh, Adham Elmously, Alfons Pomp, Gregory Dakin, Omar Bellorin, Katherine D. Gray, and Maureen D. Moore
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,Sleeve gastrectomy ,Bariatrics ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Operative Time ,Gastric Bypass ,Bariatric Surgery ,030209 endocrinology & metabolism ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Robotic Surgical Procedures ,Gastrectomy ,Weight Loss ,medicine ,Humans ,Major complication ,Adjustable gastric band ,Perioperative Period ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,Robotics ,Perioperative ,Middle Aged ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,Patient population ,Treatment Outcome ,Operative time ,Female ,Laparoscopy ,030211 gastroenterology & hepatology ,business - Abstract
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). 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. Patients undergoing planned two-stage bariatric procedures were excluded. A total of 84 patients who underwent LRBS (n = 66) or RRBS (n = 18) were included. The index operation was adjustable gastric banding (AGB) in 39/84 (46%), sleeve gastrectomy (VSG) in 23/84 (27%), Roux-en-Y gastric bypass (RYGB) in 13/84 (16%), and vertical banded gastroplasty (VBG) in 9/84 (11%). For patients undergoing conversion from AGB (n = 39), there was no difference in operative time, length of stay, or complications by surgical approach. For patients undergoing conversion from a stapled procedure (n = 45), the robotic approach was associated with a shorter length of stay (5.8 ± 3.3 vs 3.7 ± 1.7 days, p = 0.04) with equivalent operative time and post-operative complications. There were three leaks in the LRBS group and none in the RRBS group (p = 0.36). Major complications occurred in 3/39 (8%) of patients undergoing conversion from AGB and 2/45 (4%) of patients undergoing conversion from a stapled procedure (p = 0.53) with no difference by surgical approach. RRBS is associated with a shorter length of stay than LRBS in complex procedures and has at least an equivalent safety profile. Long-term follow-up data is needed. more...
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- 2018
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21. Laparoscopic Roux-en-Y Double Fistulo-Jejunostomy for Chronic Gastric Leaks After Converted Vertical Banded Gastroplasty to Sleeve Gastrectomy
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Jean Gugenheim, Jean Hubert Etienne, Vincent Casanova, Imed Ben Amor, Panagiotis Lainas, Ibrahim Dagher, and Radwan Kassir
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Reoperation ,medicine.medical_specialty ,Sleeve gastrectomy ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Jejunostomy ,Anastomotic Leak ,030209 endocrinology & metabolism ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Gastrectomy ,Surgical Stapling ,medicine ,Humans ,Treatment Failure ,Laparoscopy ,Salvage Therapy ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Stomach ,Anastomosis, Roux-en-Y ,Middle Aged ,Roux-en-Y anastomosis ,Obesity, Morbid ,Surgery ,Banded gastroplasty ,Dissection ,Chronic Disease ,Staple line ,Female ,030211 gastroenterology & hepatology ,Complication ,business - Abstract
As laparoscopic sleeve gastrectomy (LSG) is becoming the most popular bariatric procedure worldwide, treatment options for managing complications, in particular gastric leaks, are also emerging. Staple line leak is a major short-term complication of the procedure. Patients with persistent gastric leaks after failure of endoscopic and radiologic management are candidates for salvage surgery. Laparoscopic Roux-en-Y fistulo-jejunostomy (RYFJ) represents a surgical option to treat persistent gastric leak post-LSG. We present the case of a 55-year-old woman undergoing laparoscopic double RYFJ for persistent gastric leaks after complicated bariatric surgery. The patient developed two chronic gastric leaks (gastro-esophageal and cardial localizations) following conversion to sleeve gastrectomy for failed vertical banded gastroplasty. With the two leaks being refractory to endoscopic treatment 6 months later after laparoscopic sleeve gastrectomy, salvage surgery was proposed. Surgery was performed laparoscopically, the gastric leak orifices were identified after careful dissection, and a double RYFJ was successfully completed. Postoperative course was uneventful. The patient remains in good health 6 months after surgery. Double LRYFJ for chronic leaks after complicated bariatric procedures seems safe with good postoperative outcomes. However, it remains a challenging procedure and should be reserved for selected patients in specialized bariatric centers. more...
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- 2019
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22. S402 The Impact of Vertical-Banded Gastroplasty and Subsequent Revision on the Development and Severity of GERD
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Dariush Jahandideh, Samantha Magier, Mayra Sanchez, Andrew J. Duffy, and Amir Masoud
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medicine.medical_specialty ,Hepatology ,business.industry ,Subsequent revision ,General surgery ,Gastroenterology ,GERD ,medicine ,medicine.disease ,business ,Banded gastroplasty - Published
- 2021
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23. Iodine Status After Bariatric Surgery—a Prospective 10-Year Report from the Swedish Obese Subjects (SOS) Study
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Penelope Trimpou, Robert Eggertsen, Sofia Manousou, Kerstin Landin-Wilhelmsen, Lena Hulthén, Lena M. S. Carlsson, Helena Filipsson Nyström, Per-Arne Svensson, and Peter Jacobson
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Adult ,Male ,medicine.medical_specialty ,Gastric bypass ,Malabsorption ,Gastroplasty ,Original Contributions ,Endocrinology, Diabetes and Metabolism ,Population ,chemistry.chemical_element ,030209 endocrinology & metabolism ,Iodine ,Obese ,Excretion ,03 medical and health sciences ,0302 clinical medicine ,Vertical gastric banding ,medicine ,Humans ,Postoperative Period ,education ,Bariatric surgery ,Sweden ,education.field_of_study ,Nutrition and Dietetics ,business.industry ,Thyroid ,Middle Aged ,medicine.disease ,Iodine deficiency ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,medicine.anatomical_structure ,chemistry ,Case-Control Studies ,Female ,030211 gastroenterology & hepatology ,Obese subjects ,business ,Swedish Obese Subjects study ,Follow-Up Studies - Abstract
Context Bariatric surgery can lead to nutrient deficiencies. Gastric by-pass (GBP) entails restriction and malabsorption, whereas, vertical banded gastroplasty (VBG) is only restrictive. Objective The objective of this study is to study whether GBP-patients develop iodine deficiency from malabsorption, and if GBP- and VBG-patients develop lower 24-h urinary iodine excretion (24-UIE) than obese non-operated controls (OB-controls) due to lower iodine intake. Design The Swedish Obese Subjects (SOS) study is a prospective, non-randomized study of 4047 obese patients included 1987–2001, who chose bariatric surgery or non-surgical treatment. SOS-groups were compared at baseline, after 2 and 10 years and with population-based subsamples (MONICA-controls). Patients One hundred eighty-eight GBP-patients were matched with 188 VBG-patients and 188 OB-controls and with three subgroups from 412 MONICA-controls. Main Outcome Measurements Primary outcome was 24-UIE. Secondary outcomes were iodine intake, iodine supplementation, TSH, FT4, and thyroid morbidity. Results At baseline, median 24-UIE was higher in GBP-patients, VBG-patients and OB-controls than in MONICA-controls (214, 201, 203 and 137 μg/day, p more...
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- 2017
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24. A comparison of revisional and primary bariatric surgery
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Shazeer Karmali, Caroline Sheppard, Christopher de Gara, Daniel W. Birch, and Courtney Fulton
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Adult ,Male ,Reoperation ,medicine.medical_specialty ,MEDLINE ,Bariatric Surgery ,030209 endocrinology & metabolism ,Alberta ,Body Mass Index ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Weight loss ,Outcome Assessment, Health Care ,medicine ,Humans ,Obesity ,Adjustable gastric band ,Retrospective Studies ,business.industry ,Research ,Resource constraints ,Retrospective cohort study ,Middle Aged ,Banded gastroplasty ,Surgery ,Female ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Body mass index ,Psychosocial ,Follow-Up Studies - Abstract
Revisional surgery is an important component of addressing weight regain and complications following primary bariatric surgery. Owing to provincial need and the complexity of this patient population, a specialized multidisciplinary revision clinic was developed. We sought to characterize patients who undergo revision surgery and compare their outcomes with primary bariatric surgery clinic data.We completed a retrospective chart review of bariatric revision clinic patients compared with primary bariatric surgery patients from December 2009 to June 2014.We reviewed the charts of 2769 primary bariatric clinic patients, 886 of whom had bariatric surgery, and 534 revision bariatric clinic patients, 83 of whom had revision surgery. Fewer revision clinic patients underwent surgery than primary clinic patients (22% v. 32%). The mean preoperative body mass index (BMI) was 44.7 ± 9.5 in revision patients compared with 45.7 ± 7.6 in primary bariatric surgery patients. Most revision patients had a prior vertical banded gastroplasty (VBG; 48%) or a laparoscopic adjustable gastric band (LAGB; 24%). Bands were removed in 36% of all LAGB patients presenting to clinic. Of the 134 procedures performed in the revision clinic, 83 were bariatric weight loss surgeries, and 51 were band removals. Revision clinic patients experienced a significant decrease in BMI (from 44.7 ± 9.5 to 33.8 ± 7.5,A bariatric revision clinic manages a wide variety of complex patients distinct from those seen in a primary clinic. Operative candidates at the revision clinic are chosen based on favourable medical, anatomic and psychosocial factors, keeping in mind the resource constraints of a public health care system.La chirurgie de révision est une intervention importante lors d'une reprise de poids ou lors de complications à la suite d'une chirurgie bariatrique primaire. Compte tenu des besoins provinciaux et de la complexité de cette population de patients, une clinique de révision multidisciplinaire spécialisée a été créée. Nous avons voulu caractériser les patients qui subissent une chirurgie de révision et comparer leurs résultats aux données de la clinique de chirurgie bariatrique primaire.Nous avons procédé à un examen rétrospectif des dossiers des patients de la clinique de révision bariatrique par rapport aux patients ayant subi une chirurgie bariatrique primaire entre décembre 2009 et juin 2014.Nous avons examiné les dossiers de 2769 patients de la clinique bariatrique primaire, dont 886 avaient subi une chirurgie bariatrique, et 534 patients de la clinique de révision, dont 83 avaient subi une chirurgie de révision. Un moins grand nombre de patients de la clinique de révision ont subi une chirurgie comparativement aux patients de la clinique primaire (22 % c. 32 %). L'indice de masse corporelle (IMC) préopératoire moyen était de 44,7 ± 9,5 chez les patients de la clinique de révision, contre 45,7 ± 7,6 chez les patients ayant subi la chirurgie bariatrique primaire. La plupart des patients de la clinique de révision avaient déjà subi une gastroplastie verticale (48 %) ou une pose d'anneau gastrique ajustable par voie laparoscopique (24 %). Les anneaux gastriques ont été retirés chez 36 % de tous les patients de ce dernier groupe s'étant présentés à la clinique. Parmi les 134 interventions effectuées à la clinique de révision, 83 étaient des chirurgies bariatriques (pour perte de poids) et 51 concernaient des retraits d'anneaux. Les patients de la clinique de révision ont obtenu une diminution significative de leur IMC (de 44,7 ± 9,5 à 33,8 ± 7,5,Une clinique de révision bariatrique gère une grande diversité de patients complexes, qui sont différents de la population suivie dans une clinique d'intervention primaire. À la clinique de révision, les candidats à l'opération sont choisis en fonction de facteurs médicaux, anatomiques et psychosociaux favorables, en gardant à l'esprit les ressources limitées du système de santé public. more...
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- 2017
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25. Long-Term Follow-Up of Autonomic and Enteric Measures in Patients Undergoing Vertical Banded Gastroplasty for Morbid Obesity
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Atul K. Madan, Hani Rashed, William D. Johnson, David S. Tichansky, Teresa Cutts, Thomas L. Abell, George S M Cowan, Neil E. Crittenden, and Naeem Aslam
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medicine.medical_specialty ,Long term follow up ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Eenteric nervous system ,Discriminant function analysis ,Weight loss ,Electrogastrogram ,Internal medicine ,medicine ,Autonomic nervous system ,In patient ,Obesity ,030212 general & internal medicine ,medicine.diagnostic_test ,Vertical banded gastroplasty ,business.industry ,medicine.disease ,Banded gastroplasty ,Endocrinology ,Cardiology ,Original Article ,medicine.symptom ,business ,Weight gain - Abstract
Background A multi-component model of autonomic and enteric factors may correlate with ultimate weight loss or gain after restrictive obesity surgery. This study aimed to determine relevant parameters to predict successful long-term weight loss. Methods Thirty-nine patients (four males and 35 females) with a mean age of 37.2 years were followed for over 15 years after vertical banded gastroplasty. Baseline adrenergic: postural adjustment ratio (PAR) and vasoconstriction (VC); cholinergic: electrocardiogram R-to-R interval (RRI) and enteric measure: electrogastrogram (EGG) were utilized by a discriminant function analysis to classify patients as a long-term loser or gainer. Using latest weight compared to baseline, patients were divided as 10 gainers and 29 losers. Results A discriminate model successfully predicted ultimate weight gain in 8/10 (80%) of patients who subsequently gained weight and weight loss in 24/29 (83%) of patients who lost weight for a total correct classification of 32/39 (82%). The same model with data at 3 months postoperatively predicted weight gain in 9/10 (90%) of patients and weight loss in 24/29 (83%) of patients, for a total correct classification of 34/39 (87%). Conclusions A multi-component model at baseline and 3 months postoperative can predict long-term weight outcome from restrictive obesity surgery. more...
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- 2017
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26. S3582 Gastrogastric Fistula - A Tragic Complication of Vertical Banded Gastroplasty
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Gregory Pagnotta, Dustin Uhlenhopp, Vinaya Gaduputi, and Tagore Sunkara
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medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine ,business ,Gastrogastric fistula ,Complication ,Surgery ,Banded gastroplasty - Published
- 2020
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27. S2348 Use of Lumen-Apposing Metal Stent for Management of Pouch Outlet Stenosis After Vertical Banded Gastroplasty
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Maurice Marcuard, Parth J. Parekh, and Lindsey B Cundra
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medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Stent ,Lumen (anatomy) ,medicine.disease ,Surgery ,Banded gastroplasty ,Stenosis ,medicine ,Pouch ,business - Published
- 2020
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28. The Magenstrasse and Mill Operation for Morbid Obesity.
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Johnston, David, Dachtler, Jenny, Sue-Ling, Henry, King, Roderick, and Martin, Iain
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Background: Our aim was to evolve a simpler, more physiological type of gastroplasty that would dispense with implanted foreign material such as bands and reservoirs. The Magenstrasse, or "street of the stomach", is a long narrow tube fashioned from the lesser curvature, which conveys food from the esophagus to the antral Mill. Normal antral grinding of solid food and antro-pyloro-duodenal regulation of gastric emptying and secretion are preserved. Methods: 100 patients with morbid obesity (83M, 17F, mean age 40 years) were treated by the Magenstrasse and Mill procedure and followed-up for 1-5 years. Mean preoperative BMI was 46.3 kg/m
2 , and mean excess weight was 106%. Results: Operative mortality was 0. Major complications occurred in 4% of patients.There were few side-effects, although mild heartburn was fairly common. Mean weight loss was 38 kg (±14 kg), equivalent to 60% of excess weight, achieved within 1 year of operation, after which no further significant gain or loss of weight occurred. Conclusions:The Magenstrasse and Mill procedure is the simplest and most physiological gastroplasty yet described. Many of the drawbacks of vertical banded gastroplasty, adjustable banding and gastric bypass are avoided. It is safe, has few side-effects and leads to major and durable weight losses, similar to those produced by other types of gastroplasty. [ABSTRACT FROM AUTHOR] more...- Published
- 2003
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29. Long-term Dietary Changes after Vertical Banded Gastroplasty: Is the Trade-off Favorable?
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Shai, Iris, Henkin, Yaakov, Weitzman, Shimon, and Levi, Itzhak
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Background: Insufficient data exist about the longterm health consequences of gastric restriction procedures used for treatment of obesity.The long-term nutritional changes that occur after vertical banded gastroplasty (VBG) were evaluated. Methods: All consecutive patients who underwent VBG surgery in one surgical ward were invited for a follow-up study 3-10 years after the surgery. Demographic and clinical characteristics were evaluated from the patients' medical charts. Dietary assessment was performed using a food frequency questionnaire, which included 52 frequently consumed food items. Results: Of the 122 patients who underwent VBG between 1986-1992, 75 (62%) participated in the follow-up study. The average time since surgery was 5.4±1.8 years, and the average weight loss was 24.9±12.4%. Most of the patients eat only one major meal daily, and only one-third regularly ingest solid foods. Dietary analysis revealed a decreased intake of most nutrients compared with pre-surgery, with the exception of dairy products, sweet foods and fluids. The greatest decrease was found in the consumption of fiber-rich fruits and vegetables, followed by meat, fish and complex carbohydrates. Conclusion: While the weight loss itself and the reduction in fat consumption that are seen after VBG are probably beneficial, the long-term effects of the decreased consumption of fruit, vegetables, other complex carbohydrates and fish may counterbalance these benefits. The net effect of this trade-off on future health is difficult to predict and requires long-term evaluation of clinical outcome. [ABSTRACT FROM AUTHOR] more...
- Published
- 2002
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30. The LM Proring Band® and Left Approach in Laparoscopic Vertical Banded Gastroplasty: Preliminary Results in 44 Cases.
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Lointier, P, Verdier, Ph, and Verdier, A
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Background: Morbid obesity is one of the most important social and medical issues in Western countries. Many authors have adopted a minimally invasive approach to reproduce current bariatric operations.The aim of this study is to present a personal technique for laparoscopic vertical banded gastroplasty (LVBG) and the preliminary results of 44 patients. Methods: Patients fulfilled the indications for bariatric surgery and were followed prospectively. LVBG was performed in patients who refused laparoscopic banding because of port placement and adjustment, or in patients with hiatus hernia, with or without gastroesophageal reflux disease.The technique performed consisted of a laparoscopic Mason modified-MacLean gastroplasty using only 4 ports.The circular stapler was introduced in the left anterior axillary line subcostally using the same working port as the Endo-GIA stapler. A new device, a non-adjustable silicone ring, was placed as the collar around the lower end of the gastric pouch. Results: The 44 patients underwent a satisfactory LVBG with no conversions to open surgery. Mean operative time was 80 minutes (range 45-180), hospital stay was 4 days, and all 44 operations had an uneventful postoperative course. There were 40 women and 4 men, with mean age 42.5 years (24-59). Preoperative mean weight was 118.7 kg (84.5-184), with mean BMI 44.5 (35.6-60.1). 27 of the 44 patients were selected for analysis of weight loss, selection criteria being a sufficient amount of data (>2 weight losses separated by at least 2 months). For these 27 patients, mean age 41.9 (26-59), preoperative weight 119.3 kg (95-145) and mean BMI 44.6 (38.3-53.6), weight loss data were fitted with an exponential growth function, using a quasi-Newton fit algorithm. The fitted coefficient was used to calculate % excess weight loss and BMI. Mean weight loss at 1, 3, 6 and 12 months was 9.2 kg (4.4-17.2), 24.5 kg (11.0-35.9), 29 kg (12.6-53.6), and 36.5 kg (12.8-66.5) respectively. Conclusion: LVBG has given good results thus far and may be selected as a restrictive procedure. Weight loss and resolution of comorbidities occurred, and a considerable increase in self-confidence and quality of life were reported. [ABSTRACT FROM AUTHOR] more...
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- 2002
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31. Quality of Life in Bariatric Surgery.
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Arcila, Denise, Velázquez, David, Gamino, Rosa, Sierra, Mauricio, Salin-Pascual, Rafael, González-Barranco, Jorge, and Herrera, Miguel
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Background: Bariatric surgery is the treatment of choice for morbid obesity.Since bariatric operations alter gastrointestinal anatomy, they may induce symptoms that have a negative impact on quality of life (QOL).The aim of this study was to prospectively analyze QOL after bariatric surgery. Methods: The QOL index questionnaire (GIQLI) was applied to 45 surgically treated morbidly obese patients (15 vertical banded gastroplasty, 15 Roux-en-Y gastric bypass (RYGBP), and 15 distal RYGBP) and to 15 non-operated morbidly obese controls. Follow-up was of 1-year minimum. The GIQLI evaluates physical and mental well-being, digestion and bowel habits. Results: Physical and mental well-being as well as the overall QOL were significantly higher in the operated patients. There were no significant differences in digestion and bowel habits between the groups. Differences in QOL were not related to the type of surgical procedure. Conclusion. Overall QOL was significantly better in operated than in non-operated patients. There is no negative impact of bariatric surgery on QOL related to GI symptoms. [ABSTRACT FROM AUTHOR] more...
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- 2002
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32. Laparoscopic Roux-en-Y Gastric Bypass for Severe Gastroesophageal Reflux after Vertical Banded Gastroplasty.
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Bloomberg, Richard and Urbach, David
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Background: Vertical banded gastroplasty (VBG) is sometimes associated with complications such as pouch obstruction, dilatation, and gastroesophageal reflux. This occasionally requires surgical revision, in many cases to a Roux-en-Y gastric bypass (RYGBP). Case Report: A 47-year-old woman with severe obesity developed severe symptoms of stenosis of the pouch outlet and gastroesophageal reflux 15 years after VBG. Laparoscopic conversion to a RYGBP was performed. At 9-month follow-up, she lost an additional 32 kg and had complete resolution of her reflux. Conclusion: In this patient, laparoscopic re-operative RYGBP produced additional weight loss, and improved gastroesophageal reflux that occurred many years after having a VBG. Laparoscopic conversion of a VBG to RYGBP is feasible, and may confer the benefits of other minimally invasive abdominal procedures to this high-risk patient group. [ABSTRACT FROM AUTHOR] more...
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- 2002
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33. Improvement of Weight Loss and Metabolic Effects of Vertical Banded Gastroplasty by an Added Duodenal Switch Procedure and Metabolic Effects.
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Yashkov, Yury, Oppel, Tatiana, Shishlo, Ludmila, and Vinnitsky, Leonid
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Background: Some patients who underwent vertical banded gastroplasty (VBG) need revisional operations because of poor weight loss and remaining comorbidities. The duodenal switch (DS) procedure with partial gastrectomy is known as an effective method for treatment of severe obesity and related dyslipoproteinemias and diabetes mellitus type 2 (DM2). Other investigations have shown that DS without gastric resection similarly corrects hypercholesterolemia and DM2 in the "less than" morbidly obese patients. Methods: Based on this knowledge, we performed a DS simultaneously with hernioplasty and panniculectomy in a 63-year-old woman with a fair EWL (36.4%), with remaining hypercholesterolemia and DM2 4 years after VBG. The pouch stoma diameter was 13 mm, and there was no pouch dilation nor staple-line disruption.The previously partitioned stomach was left in place. H2-blockers and polyvitamins were prescribed after operation. Results: 1 year after DS there were no postoperative complications and undesirable effects except slight anemia. DS allowed improvement in weight loss, improved carbohydrate handling without need for insulin or other hypoglycemic agents, and corrected severe hypercholesterolemia. Conclusion: DS per se in the case presented had a decisive effect on DM2 and hypercholesterolemia. DS should be kept in mind as a second-step malabsorptive procedure after a failed purely restrictive operation. [ABSTRACT FROM AUTHOR] more...
- Published
- 2001
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34. Impartial Long-Term Review of Vertical Banded Gastroplasty in a Low Volume Community Hospital Practice.
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Voitk, Andrus, Voitk, Jaan, and Joffe, Jacobo
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Background: There is some concern whether bariatric surgery can be done well at low volumes or in a community hospital setting. This paper reports an impartial assessment of 25 vertical banded gastroplasties (VBG) over 13 years in a 228-bed non-teaching community hospital. Methods: Charts were reviewed and patients interviewed by an independent investigator. Complications, weight loss, satisfaction and quality of life were assessed. Results:There were no fatalities, no splenic tears, no stomal stenosis and no symptomatic gastroesophageal reflux. Two reoperations and five incisional hernias were noted. Hypertension was eliminated in 57% and dyspnea in 55%. BMI fell from 44.3 to 34.9 kg/m2 after 6.2 years. BMI decreased more than 10 kg/m2 (10-30) for 15 patients and less than 10 kg/m2 for 10 patients (4-10 for 7, 0 for 1 and a gain for 2). 56% of patients were fully satisfied with the results. Quality of life indicated excellent physical function, physical role and lack of body pain, good general health, social function, emotional role and mental health, but lower vitality.100% felt better than a year ago. Conclusion: Results from a low-volume community hospital general surgical practice are similar to those from specialized series. Obesity is so common, its non-surgical treatment so ineffective and the VBG so well established, that excluding this intervention from community hospitals is untenable. [ABSTRACT FROM AUTHOR] more...
- Published
- 2001
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35. Laparoscopic Vertical Banded Gastroplasty: Early Experience.
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Abdallah El Fiky, Khaled
- Abstract
Background: The tremendous development of laparoscopic surgery in the last decade is being applied to bariatric surgery. Laparoscopic vertical banded gastroplasty (LVBG) is technically feasible by laparoscopy. Methods: From August 1998 to August 1999, 13 patients underwent LVBG. The technical difficulties are discussed. Results: Operating time ranged from 105 to 420 minutes. 11 patients have lost 45-55% of their original weight. Inserting an esophageal bougie no. 11 from the beginning of the operation and using the laparoscopic set-up described, made the procedure shorter, safer and easier for patients and surgeon. Conclusion: LVBG is technically feasible for the laparoscopic bariatric surgeon who is experienced in the handling and control of laparoscopic instruments and hand-eye coordination. The early results are satisfactory. Preoperative counseling is an integral step for the operation. [ABSTRACT FROM AUTHOR] more...
- Published
- 2001
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36. Weight Loss Following Vertical Banded Gastroplasty: Intermediate Results of a Prospective Study.
- Author
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Facs, Fotis, Kechagias, Ioannis, Soulikia, Klea, Rn, Aggeliki, and Rd, Nancy
- Abstract
Background: Morbidly obese patients who undergo purely restrictive bariatric operations may fail to maintain satisfactory long-term results. In an attempt to achieve the best possible outcome after restrictive procedures, we have employed preoperative selection criteria and are following this selected patient group over time in order to evaluate longterm success. Materials and Methods: From June 1994 through August 2000, 166 morbidly obese patients underwent various bariatric procedures at our institution. Of these patients, 35 underwent vertical banded gastroplasty (VBG) based on selection criteria, including degree of obesity and dietary habits and eating behavior. All patients were seen at 1, 3, 6, 9, and 12 months postoperatively and yearly thereafter. Average follow-up time now is 4.1 years (29-75 mos.), and follow-up is 100%. A multivitamin and mineral supplement is administered to all patients for at least 6 months. Radiology examination is performed in all patients on the 4th postoperative day and at each yearly visit, in order to check for staple-line disruption and stomal stenosis. Results: Early postoperative morbidity was 5.7%. Late postoperative morbidity was 22.8%. A significant number of patients had some degree of stomal stenosis as shown by radiology examination, but to date there has been no need for surgical revision. There has been no early or late mortality.Weight loss results expressed as average percent excess weight loss (% EWL) were as follows: 61% (28-90) at 1 year, 61% (20-90) at 2 years, 57% (13-91) at 3 years, 56% (25-87) at 4 years and 37% (24-59) at 5 years following surgery. A significant number of patients with excellent weight loss had a high frequency of vomiting. Evaluation by BAROS showed that 25% of patients had an overall unsatisfactory outcome. Anemia and iron deficiency were found in 46% and 32% ofVBG patients respectively.Recurrence of preexisting comorbidities was significant if lost weight was regained. Conclusions: In spite of preoperative selection of patients for VBG, a significant percentage of patients had poor overall results in terms of weight loss, quality of life, and resolution of preexisting comorbidities. For these reasons and based on the long-term results published by others, VBG is no longer our preferred surgical option in morbidly obese patients. [ABSTRACT FROM AUTHOR] more...
- Published
- 2001
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37. Revision of Vertical Banded Gastroplasty
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Dimitar Ranev and Julio Teixeira
- Subjects
medicine.medical_specialty ,Weight regain ,business.industry ,Revisional operation ,General surgery ,Medicine ,business ,Banded gastroplasty - Abstract
Vertical banded gastroplasty (VBG) is a bariatric procedure that is rarely performed today, but was popular in the 1980s and 1990s. In the long term, a large percentage of VBG patients require reoperation. Not infrequently, these patients present to the bariatric surgeon with complications, weight regain, or both and require a technically challenging revisional operation. This chapter aims to explain the decision-making process and technical steps involved in a safe and successful revision. By summarizing the history of VBG, its evolution, and ultimately, its decline, the reader will gain a deeper understanding which could be applied to revisional bariatric surgery in general, including other more modern restrictive procedures. more...
- Published
- 2019
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38. Management of Post-Bariatric Complications
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Christopher C. Thompson, Allison R. Schulman, and Marvin Ryou
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Invasive strategy ,medicine.medical_specialty ,Sleeve gastrectomy ,medicine.diagnostic_test ,business.industry ,General surgery ,medicine.medical_treatment ,Gastric bypass ,Patient characteristics ,Endoscopy ,Banded gastroplasty ,Health problems ,Medicine ,Major complication ,business - Abstract
Obesity is one of the most significant health problems worldwide, and the prevalence has been increasing over the past decade. Despite improvement in the performance of bariatric surgery, complications are not uncommon. These complications vary according to baseline patient characteristics, the duration of time since the operation, and the type of bariatric surgery performed. Endoscopy is the cornerstone in the diagnosis of postoperative complications after bariatric surgery, and may even be performed in the early postoperative course. With an increasing number of patients being referred for endoscopic evaluation following bariatric surgery, it is essential to develop an understanding of the anatomic changes for optimal assessment and appropriate treatment of these patients. In many cases, endoscopic intervention provides both diagnostic utility and a minimally invasive strategy for management. This chapter will review the major complications, diagnosis, and management of the most commonly performed bariatric surgical procedures including Roux-en-Y gastric bypass, sleeve gastrectomy, laparoscopic adjustable banding, and vertical banded gastroplasty. more...
- Published
- 2019
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39. Long-term complications of open mason's vertical banded gastroplasty at a single tertiary center and literature review
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Eric Mirallié, Bertrand Cariou, David Jacobi, Guillaume Boulanger, Michel Krempf, Claire Blanchard, Tristan Greilsamer, Marie Guillouche, Clinique de chirurgie digestive et endocrinienne, IMAD, Centre hospitalier universitaire de Nantes (CHU Nantes), Physiopathologie des Adaptations Nutritionnelles (PhAN), and Université de Nantes (UN)-Institut National de la Recherche Agronomique (INRA) more...
- Subjects
Reoperation ,Long term complications ,medicine.medical_specialty ,Gastroplasty ,030209 endocrinology & metabolism ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Weight loss ,Weight Loss ,medicine ,Humans ,Laparoscopy ,2. Zero hunger ,medicine.diagnostic_test ,business.industry ,[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology ,General Medicine ,Esophageal cancer ,[SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism ,University hospital ,medicine.disease ,Obesity, Morbid ,3. Good health ,Surgery ,Banded gastroplasty ,030211 gastroenterology & hepatology ,medicine.symptom ,Complication ,business ,Body mass index ,[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition - Abstract
International audience; Vertical banded gastroplasty (VBG), introduced by Mason in 1982, is now discarded because of important long-term complications and technical difficulties to do revisional surgery. We investigated the long-term complications of VBG in our center and compared it with the literature data. Patients who underwent an open VBG at the University Hospital of Nantes between October 1991 and May 2006 were included. We reviewed preoperative clinical data, long-term outcome in weight loss, complications, and revisional surgeries with a long follow-up. Sixty-three patients (52 women and 11 men) were included, with a mean age of 43 ± 10 years and a body mass index of 46.7 ± 8.3 kg/m². The mean follow-up was 8.2 ± 4.2 years. At the end of follow-up, the mean excess weight loss (EWL) was 29.8%. Long-term success (excess weight loss > 50%) of the procedure was observed in 25 patients (39.7%). A second intervention was performed in 15 patients (23.8%), and three needed a third redo procedure. Six patients (40%) had this new intervention for late complications, and nine (60%) for weight regain. Weight loss is satisfying in the long term although the rate of reintervention is high. Long-term complication can be severe, especially with gastric stenosis that could lead to esophageal cancer. A second reintervention could be technically demanding, especially by laparoscopy, and the patients should be referred to a specialized center. more...
- Published
- 2019
40. Medical and Psychological Predictors for Long-Term Bariatric Success Using Primary Vertical-Banded Gastroplasty as a Model
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R van WezenbeekMartin, W NienhuijsSimon, and C M van HoutGebrand
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medicine.medical_specialty ,Nutrition and Dietetics ,business.industry ,Excess weight ,030209 endocrinology & metabolism ,Banded gastroplasty ,03 medical and health sciences ,Medical–Surgical Nursing ,0302 clinical medicine ,Physical therapy ,Absenteeism ,Medicine ,030211 gastroenterology & hepatology ,Surgery ,Psychological testing ,business ,Psychosocial ,Optimal weight - Abstract
Introduction: Bariatric surgery requires patients to implement permanent lifestyle changes that are affected by several factors. Psychological assessment seems to be essential for optimal weight loss and maintenance. The burden remains in identifying potential psychosocial predictors that might influence the long-term outcome. Therefore, this study was designed to identify those predictors for the long-term outcome after primary vertical-banded gastroplasty (VBG). Methods and Design: Patients who underwent primary VBG between 2001 and 2004 completed a number of psychological questionnaires. Additional postal questionnaires were sent to retrieve the latest medical outcome. Patients were categorized as failed or successful based on their excess weight loss at last follow-up. Results: This study identified a number of potential predictors. Failed patients showed more esthetic expectations, a more dominant character, more work absenteeism before surgery, and depend more on the procedure than successful patien... more...
- Published
- 2016
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41. Video Revisional Gastric Bypass After Vertical Banded Gastroplasty by a Hybrid Technique: Robotic and Laparoscopic
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Mohammed Ghunaim, Robert Caiazzo, Constance Laroye, and François Pattou
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Reoperation ,medicine.medical_specialty ,Nutrition and Dietetics ,Gastroplasty ,business.industry ,Endocrinology, Diabetes and Metabolism ,Gastric bypass ,Gastric Bypass ,030209 endocrinology & metabolism ,Middle Aged ,Gastrojejunal anastomosis ,Banded gastroplasty ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Robotic Surgical Procedures ,030220 oncology & carcinogenesis ,medicine ,Humans ,Female ,Laparoscopy ,business ,Hand sewn - Abstract
The video shows, step-by-step, the hybrid laparoscopic conversion of vertical banded gastroplasty (VBG) to Roux-en-Y gastric bypass (RYGB) with a robotic-assisted hand-sewn technique (HST) for gastrojejunal anastomosis (GJA). more...
- Published
- 2018
42. Vertical Banded Gastroplasty
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Tammy S. Fouse and Maria R. Ver
- Subjects
Orthodontics ,Geology ,Banded gastroplasty - Abstract
Vertical banded gastroplasty (VBG) is the construction of a small vertical pouch using a linear stapler, with addition of a Marlex band placed through a window formed by a circular stapler. Compared to gastric bypass, VBG maintains a more normal anatomy of the upper gastrointestinal tract. However, due to poor long-term outcomes and a high percentage of patients requiring revisional surgery, most bariatric surgeons have abandoned VBG as a primary bariatric procedure. Early complications include acute gastric distention and gastric leaks. Late complications include mesh migration or erosion, stomal stenosis, staple-line disruption, and gastrogastric fistulas. The most common revision is to Roux-en-Y gastric bypass (RYGB). There are reports of other revisions, such as the vertical banded gastroplasty−gastric bypass (VBG-GB), re-VBG, RYGB-on-VBG, VBG to duodenal switch, VBG to biliopancreatic diversion, VBG to sleeve gastrectomy, VBG to adjustable gastric band, and VBG reversal, as well as endoscopic alternatives. more...
- Published
- 2018
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43. Specialty Article: so You Think You Got a Bypass? A Case Series of Adventures in Bariatric Surgery
- Author
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Timothy Shope and Eugene Wang
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Adult ,Male ,medicine.medical_specialty ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,Fistula ,medicine.medical_treatment ,Specialty ,Gastric Bypass ,Jejunostomy ,Bariatric Surgery ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Gastrectomy ,Weight Loss ,Operative report ,Medicine ,Upper gastrointestinal ,Humans ,Retrospective Studies ,Nutrition and Dietetics ,business.industry ,nutritional and metabolic diseases ,Middle Aged ,medicine.disease ,Work-up ,Banded gastroplasty ,Surgery ,Obesity, Morbid ,030211 gastroenterology & hepatology ,Female ,Weight Loss Surgery ,business - Abstract
To raise awareness for surgeons encountering bariatric patients with anatomy that deviates from the standard Roux-en-Y gastric bypass (RYGB). This is a single-institution retrospective case series over 12 years (2003–2014) involving patients who believed they received RYGBs, but actually did not. Data was obtained reviewing physician encounters, imaging, and operative reports. There were six cases with confusing clinical pictures, found to have aberrant RYGB anatomy: (1) gastric bypass with jejuno-jejunostomy only without gastrojejunostomy, (2) distal partial vertical gastrectomy without expected prosthetic band, (3) inverse vertical banded gastroplasty, (4) non-divided gastric bypass with no gastrojejunostomy, (5) 20-cm Roux limb, with gastro-gastric fistula, and (6) 200-cm bilio-pancreatic limb similar to the traditional Scopinaro procedure. There are cases of “Roux-en-Y gastric bypasses” that have no resemblance to the named procedure at all. Adjunctive upper gastrointestinal studies and upper endoscopies help surgeons make diagnoses that are incongruent with the surgical history. It is important to keep in mind that there could be anatomic or surgical variations which were born out of necessity or based on other surgeons’ creativities. more...
- Published
- 2018
44. 1691 Lumen-Apposing Metal Stent Assisted ERCP in Stenosis Associated With Silastic Ring in Vertical Banded Gastroplasty
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Prianka Gajula and Sunil Dacha
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medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Lumen (anatomy) ,Stent ,Silastic ring ,medicine.disease ,Surgery ,Banded gastroplasty ,Stenosis ,medicine ,business - Published
- 2019
- Full Text
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45. Endoscopic reversal of vertical banded gastroplasty: a novel use of electroincision
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Jessica X. Yu, Arpan Patel, and Ryan Law
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Gastric Fistula ,Reoperation ,medicine.medical_specialty ,Gastroplasty ,Gastric Outlet Obstruction ,business.industry ,General surgery ,Treatment outcome ,Gastroenterology ,MEDLINE ,Middle Aged ,Video-Audio Media ,Obesity, Morbid ,Banded gastroplasty ,Postoperative Complications ,Treatment Outcome ,Gastroscopy ,medicine ,Humans ,Female ,business - Published
- 2019
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- View/download PDF
46. Laparoscopic conversion of failed vertical banded gastroplasty to Roux-en-Y gastric bypass or biliopancreatic diversion
- Author
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Nir Wasserberg, Hanoch Kashtan, Andrei Keidar, Matan Ben David, Samir Abu-Gazala, and Eran Sadot
- Subjects
Adult ,Male ,Reoperation ,medicine.medical_specialty ,Gastroplasty ,Gastric bypass ,Gastric Bypass ,Bariatric Surgery ,Risk Assessment ,behavioral disciplines and activities ,Body Mass Index ,Cohort Studies ,Hospitals, University ,Weight loss ,Weight Loss ,mental disorders ,Humans ,Medicine ,Israel ,Biliopancreatic Diversion ,Retrospective Studies ,business.industry ,nutritional and metabolic diseases ,Middle Aged ,Roux-en-Y anastomosis ,Single surgeon ,Obesity, Morbid ,Banded gastroplasty ,Surgery ,Treatment Outcome ,Female ,Laparoscopy ,medicine.symptom ,business ,Complication ,Body mass index ,Follow-Up Studies - Abstract
Background The Silastic ring vertical gastroplasty (SRVG), a modification of Mason's vertical banded gastroplasty (VBG), was the restrictive procedure of choice for many bariatric surgeons. The reoperation rate for failure/complications reported in long-term studies is approximately 50%. Objective We report our experience in laparoscopic conversion of failed SRVG to Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Setting A single surgeon's experience at a university-affiliated hospital. Methods Between March 2006 and April 2014, 39 patients underwent conversion of SRVG to laparoscopic RYGB (n = 25) or BPD (n = 14). The outcomes were retrieved from a prospectively collected database and analyzed. Results Most (89%) of the conversions were completed laparoscopically. The mean operative time was 195 and 200 min for RYGB and BPD, respectively. There was no mortality. Complications occurred in 11 patients (28%), 5 in RYGB (19%) and 6 in BPD (42%). At the 3-year follow-up, the mean body mass index decreased from 47±8 kg/m 2 to 26±4 kg/m 2 for BPD, and from 43 kg/m 2 to 34 kg/m 2 ( P = .05) for RYGB. Weight (kg) decreased from 110 to 84 and to 92, and from 123 to 81 and 68, at 1 and 3 years for RYGB and BPD, respectively. Conclusions The weight loss for RYGB and BPD was equal at 1 year but tended to be better for BPD at 3 years postoperatively. Laparoscopic conversion of failed VBG to RYGB or BPD was feasible, but it was followed by prohibitively high complication rates in BPD patients. The risk:benefit ratio of these procedures in this series is questionable. more...
- Published
- 2015
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47. Predictors of Hospital Readmission after Bariatric Surgery
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Christa Abraham, Christopher R. Werter, Avinash Bhakta, Paul T. Singh, Marcel Tafen, Steven C. Stain, Todd D. Beyer, Ashar Ata, Ujas S. Shah, and Yusef M. Hazimeh
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Bariatric Surgery ,Patient Readmission ,Risk Assessment ,Young Adult ,symbols.namesake ,Postoperative Complications ,Risk Factors ,Diabetes mellitus ,medicine ,Humans ,Obesity ,Poisson Distribution ,Major complication ,Poisson regression ,Aged ,Aged, 80 and over ,Hospital readmission ,business.industry ,Middle Aged ,medicine.disease ,Readmission rate ,Pulmonary embolism ,Surgery ,Banded gastroplasty ,symbols ,Operative time ,Female ,business - Abstract
Background Identification of factors that might predict readmission after bariatric surgery could help surgeons target high-risk patients. The purpose of this study was to identify comorbidities, surgical variables, and postoperative complications associated with readmission. Study Design Patients with bariatric surgery as their primary procedure were identified from the 2012 American College of Surgeons (ACS) NSQIP database. Patient variables, operative times, and major postoperative complications were analyzed for predictors of readmission. The ACS NSQIP estimated probability of morbidity (MORBPROB) was also considered. Chi-square tests and Poisson regression were used for statistical analysis to identify significant predictors. Results There were 18,186 patients who met inclusion criteria. There were 1,819 who had a laparoscopic gastric band, 9,613 who had laparoscopic Roux-en-Y gastric bypass (RYGB), 6,439 who had gastroplasties (vertical banded gastroplasty and sleeve), and 315 who had open RYGB. Age, sex, BMI, American Society of Anesthesiologists (ASA) class, diabetes, hypertension, steroid use, type of procedure, and operative time all were significantly associated with readmission within 30 days of operation. All major postoperative complications were significant predictors of readmission. Patients expected to be at high risk based on the ACS NSQIP MORBPROB had a significantly higher rate of readmissions. The overall readmission rate for patients undergoing bariatric surgery was 5%. The readmission rate among patients with any major complication was 31%. Conclusions Bariatric surgery is a low-risk procedure. Complexity of operation, ASA class, prolonged operative time, and major postoperative complications are important determinants of high risk for readmission. The ACS NSQIP MORBPROB may be a useful tool to identify and target patients at risk for readmission. more...
- Published
- 2015
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48. Laparoscopic Roux-en-Y Gastric Bypass After Open Vertical Banded Gastroplasty in Patient with Severe GERD
- Author
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Gabriel Salcedo Cabañas, Peter Vorwald, Maria Posada Gonzalez, and Rafael Mauricio Restrepo Núñez
- Subjects
Adult ,Reoperation ,medicine.medical_specialty ,Gastroplasty ,Endocrinology, Diabetes and Metabolism ,Gastric bypass ,Gastric Bypass ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,In patient ,Nutrition and Dietetics ,business.industry ,medicine.disease ,Roux-en-Y anastomosis ,humanities ,digestive system diseases ,Surgery ,Banded gastroplasty ,Obesity, Morbid ,GERD ,Gastroesophageal Reflux ,030211 gastroenterology & hepatology ,Female ,Laparoscopy ,business - Abstract
This video shows a laparoscopic reintervention after an open, vertical banded gastroplasty in a 39-year-old woman presenting with untreatable GERD.
- Published
- 2017
49. Comparing Weight Loss in Three Bariatric Procedures
- Author
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M. Bekheit and A.S. Elward
- Subjects
medicine.medical_specialty ,Gastric banding ,business.industry ,Gastric bypass ,Outcome measures ,030209 endocrinology & metabolism ,Roux-en-Y anastomosis ,Surgery ,Banded gastroplasty ,03 medical and health sciences ,0302 clinical medicine ,Weight loss ,medicine ,030211 gastroenterology & hepatology ,medicine.symptom ,business - Abstract
Weight loss is one of the most ubiquitously reported outcome measures after bariatric surgery. Indeed, this metric could be considered the center of focus of bariatric surgery. The potency of an intervention is generally judged by the magnitude of weight loss induced following surgery, and the longer lasting the weight loss, the more likely the intervention will gain publicity. more...
- Published
- 2017
- Full Text
- View/download PDF
50. Four Decades of Bariatric Surgery in a Community Hospital of Spain
- Author
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Aniceto Baltasar, is F, R Martínez, Carlos Serra, Marcelo Bengochea, Luis Cipagauta, Rafael Bou, and Nieves Pérez
- Subjects
medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,Gastric bypass ,Community perspective ,Duodenal switch ,Community hospital ,Patient management ,Surgery ,Banded gastroplasty ,Medicine ,Community setting ,business ,Laparoscopy - Abstract
Introduction: Bariatric surgical practice changes in the community setting may be under-reported. We present the developments in a Spanish bariatric surgical practice in the community setting of Alcoy from its origin in 1977 through the present. Methods: Bariatric surgical techniques employed in a country community setting over the course of nearly four decades were reviewed retrospectively and qualitatively. Results: Surgeons and medical professionals from Alcoy, Spain were involved in the evolution of bariatric surgery patient management and surgical technique from 1977s through 2017. During the last 40 years, 1,475 patients were treated in our clinics. Spanish bariatric surgeons contributed to advances in gastric bypass in the 1970s, vertical banded gastroplasty in the 1980s, bilio-pancreatic diversion/duodenal switch in the 1990s, and innovations associated with laparoscopy from the 1990s onward. Outcomes and approaches to prevention and treatment of bariatric surgical complications are reviewed from a community perspective. Contributions to the bariatric surgical nomenclature and weight-loss reporting are noted. Conclusions: The practice of bariatric surgery in the community setting must be updated continuously, as in any human and surgical endeavor. Medical professionals in community bariatric practices should contribute their experiences to the field through all avenues of scientific interaction and publication. more...
- Published
- 2017
- Full Text
- View/download PDF
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