Laparoscopic Bypass Reversal for Intractable Nausea and Vomiting Using a Circular Stapler - A Video Case Report
No external funding was provided for this video case report.
AbstractIntroductionUp to 30 % of patients undergoing bariatric surgery are dissatisfied with treatment outcomes in the long term. The aim of this study was to examine overall satisfaction with treatment 5 years after bariatric surgery and its association with body mass index (BMI) and health-related quality of life (HRQOL).MethodsPatients were surveyed 5 years after bariatric surgery; 108 patients had duodenal switch (DS) and 153 patients had laparoscopic sleeve gastrectomy (LSG). The main outcome was overall treatment satisfaction, assessed by a single question, and analyzed by multiple logistic regressi...
AbstractBackgroundVenous thromboembolism (VTE) is the most common preventable cause of 30-day post-operative mortality, with many events occurring after hospital discharge. High-level evidence supports post-discharge VTE chemoprophylaxis following abdominal/pelvic cancer resection; however, some studies support a more tailored approach. Our objectives were to (1) identify risk factors associated with post-discharge VTE in a large cohort of patients undergoing colorectal cancer resection and (2) develop a post-discharge VTE risk calculator.MethodsPatients who underwent colorectal cancer resection from 2012 to 2016 were iden...
Internal hernias (IH) are a recognized problem in laparoscopic Roux-en-Y gastric bypass (LRYGB) that can cause intestinal obstruction. The routine closure of the mesenteric defects (MDs) in the LRYGB remains controversial to prevent IH.
The patient is a 46-year-old female with a history of morbid obesity, status post laparoscopic sleeve gastrectomy at an outside institution, complicated by a left diaphragmatic thermal injury. On review of the sleeve gastrectomy operative dictation, an approximately 3 cm defect was incidentally made in the left diaphragm by a harmonic scalpel, which was repaired primarily with interrupted permanent suture at that time. She presented three years later with emesis, obstipation, and left upper quadrant abdominal pain for several days.
This video case report describes the management strategy used for an acute, sleeve leak which progressed to a chronic sleeve leak, culminating with successful endoscopic septotomy and dilation.A 52-year-old female with a body mass index of 43 underwent a laparoscopic sleeve gastrectomy at an outside facility which was complicated by leak; she underwent diagnostic laparoscopy with abdominal drain placement and was then transferred to our facility three weeks postoperatively due to ongoing purulent output from the abdominal drain.
ConclusionsWe believe that this video shows a reproducible technique for this complex anastomosis. Preservation of the distal epiploics makes the gastro-gastric anastomosis safer but requires direct dissection of the duodenum.
Evidence remains contradictory for perioperative outcomes of super-obese (SO) and super-super-obese (SSO) patients undergoing bariatric surgery.
Bleeding following laparoscopic sleeve gastrectomy (LSG) is an important complication associated with significant morbidity and a drastic increase in healthcare resources. Multiple strategies have been developed to minimize bleeding including varying bougie size, staple line reinforcement, and intra-operative tranexamic acid. These techniques, however, have been implemented without a clear understanding of the pre-, intra-, and post-operative predictors of bleeding in patients undergoing sleeve gastrectomy.
AbstractIntroduction and hypothesisSacrocolpopexy is the preferred contemporary approach to managing significant apical pelvic organ prolapse. Obesity is an established risk factor for several surgical procedures and can have a negative impact on outcomes. Our goal was to evaluate the impact of BMI on the safety and efficacy of laparoscopic sacrocolpopexy in women with pelvic organ prolapse.MethodsA single-center retrospective observational study of women undergoing laparoscopic sacrocolpopexy between January 1, 2015, and December 31, 2017.ResultsWe found 299 procedures: 82 (27.4%), 147 (49.2%) and 70 (23.4%) in women with BMI