Crura Dissection in Sleeve Gastrectomy
Condition: Post-op Complication Interventions: Procedure: Crura dissection; Procedure: Sleeve gastrectomy; Procedure: Hiatal hernia repair Sponsor: University of Miami Not yet recruiting
AbstractSleeve gastrectomy has become the most commonly performed bariatric surgery in the USA (English et al.in Surg Obes Relat Dis. 14(3):259 –63,2018). Despite the rising popularity of this procedure, gastric stenosis is a known complication with an incidence of up to 4% (Rebibo et al. in Obes Surg. 26(5):995 –1001,2016). Endoscopic pneumatic balloon dilation is increasingly utilized to treat this condition and to ameliorate symptoms of nausea, vomiting, reflux, and/or dysphagia (Dhorepatil et al. in BMC Surg. 18(1):52,2018). Pneumatic balloon dilation does carry a risk of gastric perforation of up to 3% in ...
Condition: Sleeve Gastrectomy Interventions: Procedure: Crura dissection; Procedure: Sleeve gastrectomy; Procedure: Hiatal hernia repair Sponsor: University of Miami Not yet recruiting
Conclusions: Leakage rate reduction with acellular dermal matrix reinforcement of anastomotic site was not detected in this investigation. However, postoperative inflammation levels and numerical predictors of anastomotic leakage development were significantly lower with acellular dermal matrix reinforcement of surgical anastomosis. This finding is worthy of further investigation, as reduction of inflammation with anastomotic site reinforcement is a novel finding, and more in-depth research may lead to discoveries on the physiologic role of the surgical anastomosis in post-gastrectomy patients. In addition, lower CRP and N...
AbstractPurposePerforated peptic ulcer (PPU) complicates 2 to 10% of patients with peptic ulcer disease and has mortality risk of up to 20%. Omental patch repair is the mainstay of surgical management and gastric resectional procedures are advocated for a large/giant ulcer or suspected malignancy. Emergency gastrectomy is associated with increased morbidity and mortality. The aim of this study is to compare the outcomes of omental patch repair with gastrectomy in patients with large PPU ( ≥ 20 mm).MethodsA retrospective review of all PPU patients who underwent surgery from January 2008 to December 2014 was d...
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10% and 20% in Western populations with an even higher incidence in populations with obesity . The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone laparoscopic Roux-en-Y gastric bypass (LRYGB). De Goot et al. , in their 2009 meta-analysis, demonstrated improvement in GERD in people with obesity after LRYGB.
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10 to 20% in western populations with an even higher incidence in populations with obesity (1). The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone Laparoscopic Roux En Y Gastric Bypass (LRYGB). De Goot et al in their 2009 meta-analysis demonstrated improvement in GERD in people with obesity following LRYGB(2).
This Video demonstrates a case where accidental stapling of the temperature probe occurred during performance of a Laparoscopic Sleeve gastrectomy. The temp robe was released after sharp dissection and we closed the resulting gastrotomy in two layers and secured omentum over the repair. The patient has done well in the psotoperative period. While our institution and OR team has a long-standing policy of no placement of esophageal temperature probes, or naso- or orogastric tubes during any bariatric or foregut case that will require stapling.
Gastric herniation following laparoscopic sleeve gastrectomy is a surgical complication presented in up to 37% of cases in some studies. The intrathoracic migration of the stomachcan happen as early as 1 month after surgery.
Mild Dumping syndrome is common but severe dumping syndrome is rare and needs revisional surgery after Roux-en-Y gastric bypass(RYGB).
74-year-old female with a history of sleeve gastrectomy with hiatal hernia repair 5 years ago presented complaining of severe reflux. Patient had successful weight loss but developed recurrence of her severe reflux and hiatal hernia. She underwent hiatal hernia repair with anterior fundoplication 6 months ago to no avail.