Value of robotic-assisted technique in redo gastrojejunostomy for severe stenosis after gastric bypass

AbstractDevelopment of gastrojejunal stricture following Roux-en-Y gastric bypass (RYGB) leads to an increase in morbidity and adverse effects, such as abdominal pain, vomiting, aspiration pneumonia, and malnutrition. Up to 38.5% of patients will require revisional surgery for late anastomotic strictures despite conservative treatment. However, no previous studies focused on revisional robotic bariatric surgery due to strictures after RYGB have been reported. To evaluate our outcomes and assess the advantages of the robotic platform with regard to laparoscopic and open revisional procedures. University Hospital. We performed a retrospective analysis of patients who underwent laparoscopic robotic-assisted redo gastrojejunostomy from 2016 to 2018. Demographics, surgical data, medical treatments, postoperative outcomes, and adverse effects were collected. Nine patients with symptomatic anastomotic strictures after primary RYGB underwent robotic revisional surgery. All patients received medical therapy as a first approach, and five patients (55.5%) underwent endoscopic balloon dilation. All procedures were successfully completed with robotic assistance, with a mean (standard deviation) operative time of 184.5 (49.1)  min, and no intraoperative adverse effects were registered. Median (range) hospital stay was 2 (1–4) days. One patient presented with a postoperative intra-abdominal abscess and was treated with intravenous antibiotics and image-guided drainage. No an...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research

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When patients started showing up in doctors’ offices and emergency departments with coughs, shortness of breath, chest pain, nausea, vomiting, abdominal pain, diarrhea, fever, chills and weight loss, physicians’ first instincts were that the cause of these symptoms were common illnesses such as pneumonia or flu. But treatments that are usually highly effective for these […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Pulmonology Source Type: blogs
The struggle is real. A bit more than a year ago, I wrote an article for Psych Central called Do You Have FOMO? In a study called “Motivational, emotional, and behavioral correlates of fear of missing out,” it is defined as: “a pervasive apprehension that others might be having rewarding experiences from which one is absent, FOMO is characterized by the desire to stay continually connected with what others are doing.”   The manner in which it arrived in my life had little to do with being envious with what I saw on social media, and all the way-cool things others were doing, like traveling to ...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Habits Happiness Personal Technology fear of missing out social media Source Type: blogs
Publication date: November 2019Source: Journal of the American College of Radiology, Volume 16, Issue 11, SupplementAuthor(s): Expert Panel on Thoracic Imaging, Christopher Lee, Patrick M. Colletti, Jonathan H. Chung, Jeanne B. Ackman, Mark F. Berry, Brett W. Carter, Patricia M. de Groot, Stephen B. Hobbs, Geoffrey B. Johnson, Fabien Maldonado, Barbara L. McComb, Betty C. Tong, Christopher M. Walker, Jeffrey P. KanneAbstractThe immunocompromised patient with an acute respiratory illness (ARI) may present with fever, chills, weight loss, cough, shortness of breath, or chest pain. The number of immunocompromised patients con...
Source: Journal of the American College of Radiology - Category: Radiology Source Type: research
We report an uncommon case of septic arthritis of the ankle from a Streptococcus pneumoniae infection and provide an update of the literature reported since 2002. A 58-year-old female presented to the hospital with right ankle pain and an inability to bear weight. She reported a history of productive cough, vomiting, diarrhea, and subjective fevers 4 days earlier. Streptococcus pneumonia was identified in her ankle aspirate, and she was treated urgently with operative incision and debridement, followed by postoperative intravenous antibiotics. At her 7-week follow-up, she demonstrated complete resolution of symptoms and ne...
Source: The Journal of Foot and Ankle Surgery - Category: Orthopaedics Source Type: research
Rationale: Pulmonary embolism (PE) is one of the serious cardiopulmonary diseases that can endanger life. Early diagnosis and timely treatment are key factors to reduce its high mortality rate. Abdominal pain is not currently included in the symptoms of PE in textbooks and guidelines. Patient concerns: A 49-year-old man was hospitalized for an exacerbation of right upper quadrant abdominal pain and sudden left upper quadrant pain that lasted for 2 hours. Diagnoses: The patient was initially misdiagnosed as cholecystitis and pneumonia, and later was diagnosed as PE by computed tomography pulmonary angiography (CTP...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We report an uncommon case of septic arthritis of the ankle from a Streptococcus pneumoniae infection and provide an update of the literature reported since 2002. A 58-year-old female presented to the hospital with right ankle pain and an inability to bear weight. She reported a history of productive cough, vomiting, diarrhea, and subjective fevers 4 days earlier. Streptococcus pneumonia was identified in her ankle aspirate, and she was treated urgently with operative incision and debridement, followed by postoperative intravenous antibiotics.
Source: Journal of Foot and Ankle Surgery - Category: Orthopaedics Authors: Source Type: research
Conclusion: Laparoendoscopic single-site surgery may be a feasible and safe technique for staging early-stage ovarian/tubal cancer. This approach has some advantages included providing easier access to the upper abdominal regions when performing high-level infrarenal para-aortic lymphadenectomy; the 2-cm elastic incision favors fast specimen extraction and colpotomy are avoided. However, the long-term oncologic outcomes need to be further investigated. PMID: 31595144 [PubMed - in process]
Source: JSLS : Journal of the Society of Laparoendoscopic Surgeons - Category: Surgery Tags: JSLS Source Type: research
ConclusionsThe prevalence of alcohol dependence in hospitalized patients is substantial. Although our patient was being treated with the standard protocols for alcohol withdrawal, he rapidly developed delirium tremens, which led to an acute inferior ST-elevation myocardial infarction in the setting of nonoccluded coronary vessels. This case report adds to the sparse literature documenting acute coronary events in the setting of alcohol withdrawal and suggests that our patient ’s ST-elevation myocardial infarction is not fully explained by the current coronary vasospasm hypothesis, but rather was in part the result of...
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
AbstractHypocomplementemic urticarial vasculitis syndrome (HUVS) is a small vessel vasculitis characterized by hypocomplementemia and urticaria-like exanthema. Some cases also display abdominal pain and membranoproliferative glomerulonephritis (MPGN) with immune complex deposits. We treated a case of HUVS with biopsy-proven gastrointestinal vasculitis and atypical histological findings in a kidney biopsy. The 36-year-old Japanese man, who was previously diagnosed with diffuse panbronchiolitis, visited our hospital due to transient urticaria-like exanthema and rapid deterioration of kidney function. On admission, the skin l...
Source: CEN Case Reports - Category: Urology & Nephrology Source Type: research
Conclusion: CART-related GI-AEs occur in 15% of patients treated with CART. These symptoms are typically mild and self-limiting, requiring only symptomatic treatment. Nevertheless, CART may, in rare cases, lead to refractory colitis.
Source: American Journal of Clinical Oncology - Category: Cancer & Oncology Tags: Original Articles: Experimental Therapeutics Source Type: research
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