Comparison of volume-controlled and pressure-controlled ventilation on respiratory mechanics in laparoscopic bariatric surgery: randomized clinical trial

ConclusionsPressure-controlled ventilation mode is not superior to volume-controlled ventilation mode in patients with laparoscopic bariatric surgery.ResumoJustificativaO modo de ventilação mecânica que deve ser usado em cirurgia bariátrica, uma das opções de tratamento para pacientes com obesidade, ainda não foi definido.ObjetivosComparar as ventilações controladas por volume e por pressão em termos de mecânica respiratória e dos valores da gasometria arterial em pacientes submetidos à cirurgia bariátrica laparoscópica.MétodosSessenta e dois pacientes com obesidade mórbida programados para bypass gástrico foram incluídos neste estudo. Seus pesos corporais ideais foram calculados durante as consultas pré-operatórias e os pacientes foram divididos em dois grupos: ventilação controlada por volume e ventilação controlada por pressão. Os pacientes foram ventilados de acordo com um algoritmo previamente determinado. Os parâmetros da ventilação mecânica e as análises da gasometria arterial foram registrados 5 minutos após a indução, 30 minutos após o pneumoperitônio e ao final da cirurgia. Além disso, a complacência dinâmica, a pressão e a fração de oxigênio inspirado e a pressão do grad...
Source: Brazilian Journal of Anesthesiology - Category: Anesthesiology Source Type: research

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Risk Factors for Moderate to Severe Pain during the First 24 Hours after Laparoscopic Bariatric Surgery While Receiving Intravenous Patient-Controlled Analgesia. Anesthesiol Res Pract. 2019;2019:6593736 Authors: Iamaroon A, Tangwiwat S, Nivatpumin P, Lertwacha T, Rungmongkolsab P, Pangthipampai P Abstract Objective: To investigate the incidence of and risk factors for moderate to severe pain during the first 24 hours after laparoscopic bariatric surgery. Materials and Methods: This retrospective study included morbidly obese patients who underwent laparoscopic sleeve gastrectomy or Ro...
Source: Anesthesiology Research and Practice - Category: Anesthesiology Tags: Anesthesiol Res Pract Source Type: research
The laparoscopic adjustable gastric band (AGB) is associated with poor long-term weight loss and frequent untoward outcomes. Increasingly, patients are referred for revisional bariatric surgery, wherein a previously-placed adjustable gastric band is removed in favor of laparoscopic Roux-en-Y gastric bypass or sleeve gastrectomy (SG). Recently, data have emerged that argue for the safety of a 1-stage approach to these maneuvers, which offers potential benefits over a 2-stage approach including fewer instances of general anesthesia, fewer total abdominal procedures, and fewer interruptions in patients ’ lives.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
DiscussionTo our knowledge, this is the first randomized clinical trial designed to compare the effects of two different anesthetics on immunomodulation in obese patients undergoing laparoscopic bariatric surgery. Our hypothesis is that anesthesia with sevoflurane will result in a weaker proinflammatory response compared to anesthesia with propofol, with lower circulating levels of IL-6 and other proinflammatory mediators, and increased macrophage differentiation into the M2 phenotype in adipose tissue.Trial registrationRegistro Brasileiro de Ensaios Cl ínicos,RBR-77kfj5. Registered on 25 July 2018.
Source: Trials - Category: Research Source Type: clinical trials
CONCLUSIONS: We found no significant differences between the 2 anesthetic regimens regarding postoperative nausea and pain, awakening time, peritoneal stretch, or the use of perioperative muscle relaxants. PMID: 31227317 [PubMed - as supplied by publisher]
Source: Surgery for Obesity and Related Diseases : official journal of the American Society for Bariatric Surgery - Category: Surgery Authors: Tags: Surg Obes Relat Dis Source Type: research
ConclusionsThe severity and incidence of PONV are similar following SG and GB. Importantly, there was no difference in hospital utilization due to PONV between SG and GB.
Source: Obesity Surgery - Category: Surgery Source Type: research
Conservative obesity treatment often leads to limited results. Bariatric surgery is highly efficient, but the candidates are at risk of developing perioperative complications. Bariatric outcomes have been well...
Source: BMC Anesthesiology - Category: Anesthesiology Authors: Tags: Research article Source Type: research
ConclusionsUnlike previous studies, we found no difference in early complication rates between LRYGB and LSG in a comparable cohort when performed by a surgeon with sufficient experience in bariatric surgery.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
Abstract Introduction Laparoscopic Roux-en-Y gastric bypass (LRYGB) is technically demanding and has an associated learning curve. We published previously that bariatric fellowship reduces the learning curve of primary LRYGB and improves patient outcomes after one year of independent practice. However, the long-term effect of fellowship is unknown. We therefore aimed to compare the 30-day outcomes of LRYGB between the first year of a surgeon's independent practice with the subsequent six years. Materials and methods A prospective database of patients undergoing primary LRYGB under a single surgeon from March 2010 ...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
ConclusionsFindings showed that male gender and higher patient age were independent predictors of lower surgeon satisfaction with the workspace during laparoscopic bariatric surgery. Male gender also had a significant role in predicting longer surgery duration. The role of android obesity, which is more frequently associated with male gender, in affecting surgeon-perceived workspace conditions needs further investigation.
Source: Obesity Surgery - Category: Surgery Source Type: research
[Robot-assisted vs laparoscopic gastric bypass : First experiences with the DaVinci system in bariatric surgery]. Chirurg. 2018 Mar 27;: Authors: Beckmann JH, Aselmann H, Egberts JH, Bernsmeier A, Laudes M, Becker T, Schafmayer C, Ahrens M Abstract Conventional laparoscopy is the gold standard in bariatric surgery. Internationally, robot-assisted surgery is gaining in importance. Up to now there are only few reports from Germany on the use of the system in bariatric surgery. Since January 2017 we have been performing robot-assisted gastric bypass surgery. It remains unclear whether the use of the...
Source: Der Chirurg - Category: Surgery Authors: Tags: Chirurg Source Type: research
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