A641 Less is More: Avoiding Conversion to RYGB with LINX placement after Sleeve Gastrectomy

Laparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric procedure in obesity management. Gastroesophageal reflux disease (GERD) in this population has reported rates of 23-100% GERD after LSG . GERD after LSG has been noted with recent studies demonstrating de novo reflux or symptom exacerbation despite weight loss. Fundoplication is not an option, and medically refractory GERD after LSG is usually treated with conversion to Roux-en-Y gastric bypass (RYGB). This video demonstrates the placement of a magnetic sphincter augmentation device after LSG as an alternative to conversion to RYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research

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AbstractBackgroundWhile laparoscopic sleeve gastrectomy (LSG) continues to be the most commonly performed bariatric operation, several variables influence surgeons ’ practice patterns and patients’ decision-making in the type of bariatric procedure to perform. The aim of this study was to evaluate patient factors that influence the decision between laparoscopic Roux-en-Y gastric bypass (LRYGB) versus LSG.MethodsThe Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database was queried for patients undergoing LSG and LRYGB between 2015 and 2017. Univariate analysis and multi...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
AbstractPurpose of ReviewKnowledge regarding postoperative outcomes after bariatric and metabolic surgery continues to evolve. This review highlights key findings in outcomes research over the last 5  years related to weight loss, remission of obesity-related disease, reflux, revisional surgery, robotic-assisted surgical platforms, and adolescent populations.Recent FindingsSleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) produce similar weight loss patterns at 5  years, while duodenal switch (BPD/DS) and related procedures are associated with maximal weight loss overall and optimal resolution of obesit...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research
Conclusion: GERD may improve in obese patients who underwent laparoscopic sleeve gastrectomy (LSG); however, the most favorable effect is likely to be found after Roux-en-Y gastric bypass surgery. Prospero registration number: CRD42018090074.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Study Protocol Systematic Review Source Type: research
ConclusionsForegut pathology is common in bariatric patients with subjective symptoms of GERD. Implementing a comprehensive protocol to objectively assess these patients leads to a significant clinical impact on which procedure these patients ultimately undergo.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
This study included patients who underwent primary laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG). The primary outcome of interest was incisional SSI occurring within 30  days. Surgeries performed in 2015 were used in a derivation cohort and the predictive tool was validated against the 2016 cohort. A forward selection algorithm was used to build a logistic regression model predicting probability of SSI.ResultsA total of 274,187 patients were included with 71.7% being LSG and 28.3% LRYGB. 0.7% of patients had a SSI in which 71.0% had an incisional SSI, and 29.9% had an organ/spa...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsComparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
Source: Obesity Surgery - Category: Surgery Source Type: research
AbstractObjectiveTo evaluate the impact of laparoscopic sleeve gastrectomy (LSG) or laparoscopic Roux-en-Y gastric bypass (LRYGB) on gastroesophageal reflux disease (GERD) in patients with obesity.MethodsPatients with class II or III obesity were treated with LSG or LRYGB. Procedure choice was based on patients and surgeon preferences. GERD symptoms, endoscopy, barium swallow X-ray, esophageal manometry, and 24-h pH monitoring were obtained before and 1 year after surgery.ResultsSeventy-five patients underwent surgery (83% female, 39.3 ± 12.1 years, BMI of 41.5 ± 5.1 kg/m2): 35 (46.7%) had LSG and 40 (53.3%) ...
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionsBoth LRYGB and LSG have comparative effect on resolving T2DM in nonseverely obese patients at midterm follow-up. Further RCTs should address the potential risks and long-term effects of LRYGB and LSG in nonseverely obese patients.
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionLBPD/DS or DJB as revision surgery appears to be effective for further weight loss in the medium term, and LRYGB appears to be effective for GERD remission. Bariatric surgeons should bear in mind, however, that the post-LRYGB complication rate appears to be relatively high.
Source: Obesity Surgery - Category: Surgery Source Type: research
Abstract INTRODUCTION: Studies have attempted to identify prognostic indicators for successful outcomes following bariatric surgery for obesity. The aim of this study was to determine whether the degree of obesity affects outcomes in patients who are morbidly obese (basal metabolic index, BMI, 40-49.9 kg/m2), super-obese (BMI 50-59.9 kg/m2) and super-super-obese (BMI greater than 60 kg/m2) undergoing restrictive or malabsorptive bypass procedures. MATERIAL AND METHODS: Retrospective analysis of a prospectively maintained database was undertaken to include all consecutive laparoscopic adjustable gastric bands ...
Source: Annals of the Royal College of Surgeons of England - Category: Surgery Authors: Tags: Ann R Coll Surg Engl Source Type: research
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