Laparoscopic Repair of Diaphragmatic Hernia with Mesh Following Sleeve Gastrectomy

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.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research

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We present the first case of bariatric surgery in a patient with Ehlers-Danlos syndrome and outline management challenges in the context of the relevant literature. A 56-year-old man with type IV Ehlers-Danlos syndrome and a body mass index of 41.8 kg/m2 was referred to the bariatric centre of the Churchill Hospital, Oxford, for consideration of surgery for morbid obesity. His comorbidity included type 2 diabetes, hypertension, dyslipidaemia and obstructive sleep apnoea. He underwent a laparoscopic Roux-en-Y gastric bypass. His initial recovery was uneventful and he was discharged on the first postoperative day. Six weeks ...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
Conclusions: Between January and December 2018, 33 patients underwent surgery between two units. Indications for surgery included dysfunctional uterine bleeding, endometrial hyperplasia, pelvic pain, post-menopausal bleeding, prophylactic surgery in BRCA positive patients and one grade 1 stage 1 endometrial cancer in whom laparoscopic hysterectomy was technically difficult and complicated by previous midline laparotomy. Ages ranged from 35-75 and BMI from 20-53.Mean operation time was 68.5 minutes and mean blood loss intraoperatively was 269mls. 15.2% (n = 5) had a blood loss equal or more than 500&thi...
Source: European Journal of Obstetrics and Gynecology and Reproductive Biology - Category: OBGYN Source Type: research
The patient was a 46-year-old female with a history of morbid obesity and was post –laparoscopic sleeve gastrectomy (performed 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; this was repaired pri marily with interrupted permanent suture at that time. She presented 3 years later with a several-day history of emesis, obstipation, and left upper quadrant abdominal pain.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Video Case report Source Type: research
ConclusionWe present a case report of inguinal bladder hernia in a middle-aged man that presented as left lower quadrant pain, groin pain, and dysuria. Diagnosis was confirmed preoperatively with radiographic imaging. The hernia was surgically reduced and the defect repaired without complications.
Source: International Journal of Surgery Case Reports - Category: Surgery Source Type: research
ConclusionTransjejunal LAERCP is a feasible technique to deal with choledocholithiasis, and it allows at the same time to identify and treat concomitant conditions like internal hernias.
Source: Obesity Surgery - Category: Surgery Source Type: research
This study aims to describe the clinical experience in terms of efficacy and safety with laparoscopic ventral hernia repair using the ParietexTM Composite mesh (Covidien Sofradim Production, Trevoux, France) in severely obese patients (body mass index ≥35) compared with non-severe obese patients in a seven-year single-center cohort. MATERIAL AND METHODS: All patients with a primary ventral or incisional hernia admitted to our hospital from 2006 until December 2012 who underwent a laparoscopic repair with the Parietex Composite mesh were included in this study. Pain scores using a numeric rating were collected prospe...
Source: Minimally Invasive Therapy and Allied Technologies - Category: Surgery Tags: Minim Invasive Ther Allied Technol Source Type: research
Meralgia paresthetica is a non–life-threatening neurological disorder characterized by numbness, tingling, and burning pain over the anterolateral thigh due to impingement of the lateral femoral cutaneous nerve. This disorder has been seen in patients with diabetes mellitus and obesity, but has also been observed in patients after procedures such as posterior spine surgery, iliac crest bone grafts, lumbar disk surgery, hernia repair, appendectomies, and pelvic osteotomies that ultimately lead to compression or damage to the lateral femoral cutaneous nerve. Overall, permanent sequelae of meralgia paresthetica are rare...
Source: Journal of Spinal Disorders and Techniques - Category: Surgery Tags: Narrative Review Source Type: research
Perforated duodenal ulcer after gastric bypass is rare. There have been less than 25 reported cases of duodenal perforation after Gastric bypass. Although most peptic ulcers after gastric bypass surgery occur in the roux limb as marginal ulcers, duodenal ulceration and perforated ulcers in the secretory limb can also present with acute abdominal pain with or without free air in the peritoneal cavity on imaging studies. Laparoscopy is recommended for post gastric bypass patients presenting with acute abdominal signs to rule out internal hernias and other pathology.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
The patient is a 41 year old woman presenting with severe left shoulder pain, reflux symptoms, and weight regain after Primary Obesity Surgery Endolumenal (POSE). This video details a complex revision of the POSE procedure to a laparoscopic sleeve gastrectomy. Technical skills demonstrated in the video include dissection of the plicated and densely adherent greater curvature of the stomach, mobilization of the gastric fundus from the spleen with careful vascular control of splenic vessels, freeing endolumenal sutures to the stomach and spleen, hiatal hernia repair, elevation and resection of the phrenoesophageal fat pad to...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
We are presenting a 53 year old female with a BMI of 57.   Past medical history includes OSA on CPAP, HTN, CHF, low back pain, osteoarthritis, IBS, bipolar disorder, seizure disorder and a left hepatic hemangioma that is relevant for this case. The patient had prior abdominal surgeries including laparoscopic cholecystectomy, appendectomy and 2 C-section s. She was evaluated for her morbid obesity and comorbidities and was deemed to be a good candidate for bariatric surgery.  Her preoperative workout included an upper endoscopy that was normal without esophagitis.  As a work up for an episode o...
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
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