Comment on: Laparoscopic sleeve gastrectomy as day-case surgery: a review of the literature
We read with interest the systematic review by Rebibo et al. , a thorough review of the literature as it relates to sleeve gastrectomy performed in the ambulatory surgery setting. Specifically, the authors performed a literature search on studies investigating management of perioperative risks and complications after ambulatory sleeve gastrectomy. It is important to clarify the term ambulatory surgery, which was defined both in the review and in the following editorial, as outpatient surgery after which a patient is discharged on the same day.
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.
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.
Publication date: Available online 6 August 2019Source: Trends in Endocrinology &MetabolismAuthor(s): Michael Camilleri, Annamaria StaianoFor the management of obesity in childhood and adolescence, nonoperative approaches have limited efficacy, including community-based and behavioral interventions and pharmacotherapy approved for use in adults. Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy are efficacious in reducing weight, body mass index, and comorbidities in adolescents. Understanding the phenotype associated with obesity provides an opportunity to individualize patients’ treatments dir...
This study shed some light on the modification of postoperative gut microbial composition after bariatric surgery.MethodsA prospective longitudinal study on healthy lean subjects and patients who underwent bariatric surgery (Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) was carried out. Anthropometric and metabolic data, smoking, food preferences data, and stool samples were collected from lean subjects and from obese patients before and 3 and 6 months after surgery (T0, T3, and T6, respectively).ResultsWe collected stool samples from 25 obese patients before surgery and 3 and 6 months thereafte...
There is an error in the published article. One patient ’s gender was mistaken; it has been changed from female to male. Thus, the number of male and female patients in Tables 1 and 2, and the median andp value in Table 2 are incorrect.
ConclusionWeight loss after LSG was maintained in the majority of the patients, while a small proportion has significant weight regain at 5 years. T2DM resolution and other comorbidity resolutions were well supported after LSG.
Abstract For the management of obesity in childhood and adolescence, nonoperative approaches have limited efficacy, including community-based and behavioral interventions and pharmacotherapy approved for use in adults. Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy are efficacious in reducing weight, body mass index, and comorbidities in adolescents. Understanding the phenotype associated with obesity provides an opportunity to individualize patients' treatments directed at the brain-gut axis. These phenotypes include rapid gastric emptying, increased fasting gastric volume, reduced postprandi...