Warning over new weight-loss surgery: It is causing patients to lose MUSCLE as well as fat
Left gastric artery embolization is being explored as an alternative to the invasive gastric bypass but has an unexpected side-effect, warn researchers from the Mayo Clinic.
Publication date: Available online 29 January 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Marcelo Montenegro, Helena Slongo, Cassia Raquel Teatin Juliato, Vatche Arakel Minassian, Ali Tavakkoli, Luiz Gustavo Oliveira BritoABSTRACTObjectiveTo determine the effect of bariatric surgery (BS) on the prevalence of pelvic floor dysfunctions (PFD), specifically on urinary incontinence (UI), pelvic organ prolapse (POP), and fecal incontinence (FI).Data SourcesA systematic review (PROSPERO registration no. CRD42017068452) with a literature search was performed using the PubMed, Scopus, and SciELO databases for all...
We appreciate the opportunity to respond to the letter entitled “ERCP in patients with Roux-en-Y gastric bypass: one size does not fit all” by Yang and Draganov.1 We thank our colleagues for their comments about our publication.2 The authors suggested that laparoscopic-assisted ERCP (LA-ERCP), rather than EUS-guided gastrostomy-assisted ERCP (EUS-GG-ERCP), s hould be the first approach for most Roux-en-Y gastric bypass (RYGB) patients who need a single ERCP in view of the comparable results with standard ERCP in patients with normal anatomy.
The study by Bukhari et al1 comparing EUS-guided gastrostomy-assisted ERCP (EUS-GG-ERCP) versus enteroscopy-assisted ERCP (e-ERCP) in patients with Roux-en-Y gastric bypass (RYGB) contributes new and important information on the care of these challenging patients. Technical success was significantly higher with EUS-GG-ER CP (100% vs 60%; P
Publication date: Available online 18 February 2019Source: Journal of Visceral SurgeryAuthor(s): L. Genser, J.C. Vaillant, J.M. Siksik
Introduction: Neonates born after maternal gastric bypass surgery have been shown to be often small for gestational age (SGA). However, no previous study investigated fetal growth tendencies after bariatric surgery. The exact etiology of fetal growth restriction after maternal bariatric surgery remains unknown, however previous studies suggested maternal nutritional deficits and recurrent hypoglycemia as possible causative factors.
ConclusionIn gastric bypass, creating the gastric pouch in the distal region of the stomach significantly impairs the glucose tolerance and diabetes remission in spite of the increased GLP-1 and insulin responses in T2D SD rat model, suggesting that bypassing the distal stomach may be the key mediator of early diabetes remission after RYGB.
ConclusionBoth HM and POEM seem feasible, safe, and effective in the management of achalasia after RYGB. The role of POEM in the management algorithm of these patients should be further evaluated.
ConclusionsAlthough quality of all the studies was relatively moderate and the number of the included studies was limited, the barbed suture may have the potentiality to be an effective and reliable technique and extend the application in other bariatric surgeries. More evidence with randomized design, larger sample sizes, and longer follow-up need to compel validations of this state-of-the-art in the future.
Conclusions: Registers of bariatric procedures provide information that helps in planning treatment and predicting possible complications. Adequate reporting of bariatric procedures is necessary to present the importance of the high incidence of obesity and the importance of its treatment. To collect reliable data, a national Polish bariatric surgery registry should be created. PMID: 30766633 [PubMed]
DR. JONATHAN MYERS (Chicago, Illinois): As the popularity of laparoscopic sleeve gastrectomy increases, the management of one of its known potential complications, gastro-esophageal reflux disease, remains a priority. To-date, medical management with medications such as PPIs or conversion to Roux-en-Y gastric bypass remain mainstays for those with severe symptoms. The authors are to be commended for exploring and offering a less invasive operative intervention for their patients who refused gastric bypass.