Treatment or mutilation?
I have been sitting with the following image from Dr. Sharma's Obesity Notes for a coupe of weeks now. The image is an illustration of a procedure known as sleeve gastrectomy, defined in Wikipedia as "a surgical weight-loss procedure in which the stomach is reduced to about 25% of its original size, by surgical removal of a large portion of the stomach along the greater curvature." This is not a procedure done on a diseased organ but on a healthy functioning one. When an adult chooses this procedure in order to lose weight, I understand that, though I have grave reservations about such procedures, they are adults and capable of giving informed consent. But then I read the following, reported widely in the same week that Dr Sharma wrote about the procedure: A toddler in Saudi Arabia has become the youngest patient to undergo a bariatric weight loss surgery procedure.Doctors determined the 2-year-old, weighing 73 pounds, required surgery after observing related sleep apnea and bowing of the child's legs. According to a case report published in the International Journal of Surgery earlier this month, the extreme procedure was taken only after other weight-loss methods failed. Keep in mind this is a 2 1/2 yr old child. This procedure is not approved in this country for use in children. There is no long term data on the effects because it has been av...
In this study, we have tried to evaluate the impact of bariatric surgery on the whole cohort of hypothyroid patients and compare the effect of various bariatric procedures on thyroid hormone replacement dose.
CONCLUSION: Bariatric surgery might cause reduction of thyroid replacement dosage in hypothyroid, morbidly obese patients. PMID: 32409116 [PubMed - as supplied by publisher]
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...
Conclusions: The LSG is an effective method of treatment in all areas of metabolic syndrome, provides a significant positive clinical outcome in obesity-related comorbidities and induces desirable changes in inflammatory, kidney and liver related biomarkers. PMID: 32117497 [PubMed]
ConclusionsSADI-S appears to be a safe bariatric surgical procedure with favorable outcomes at 2 years in the Australian population.
Authors: Sanches E, Timmermans M, Topal B, Celik A, Sundbom M, Ribeiro R, Parmar C, Ugale S, Proczko M, Stepaniak PS, Pujol Rafols J, Mahawar K, Buise MP, Neimark A, Severin R, Pouwels S Abstract Introduction: Obesity is associated with various diseases such as type 2 diabetes, hypertension, obstructive sleep apnea syndrome (OSAS), metabolic syndrome, and cardiovascular diseases. It affects several organ systems, including the pulmonary and cardiac systems. Furthermore, it induces pulmonary and cardiac changes that can result in right and/or left heart failure.Areas covered: In this review, authors provide an overv...
ConclusionWLG group did not have decreased perioperative morbidity, nor improved weight loss and comorbidity resolution 4 years after surgery. While these findings should also be confirmed by multicenter trials, they question the value of mandated WLG prior to bariatric surgery as they seem ineffective and may limit patient access to surgery.
We report the case of a 26-year-old man with PWS and morbid obesity (BMI 65kg/m2) since childhood. He also suffered from uncontrolled diabetes mellitus type 2, hypertension, and obstructive sleep apnea. After an unsuccessful diet and exercise program, he opted for bariatric surgery in which laparoscopic sleeve gastrectomy was performed.
Stapling of a bougie, temperature probe, or a nasogastric tube is a rare and poorly reported complication of bariatric surgery that can lead to significant morbidity in patients. The best management of such a complication is unclear. Patient is a 55-year-old gentleman with a BMI 35 kg/m2, hypertension, type 2 diabetes mellitus and obstructive sleep apnea. Patient underwent a laparoscopic sleeve gastrectomy using a 34Fr Bougie. At the end of the case, attention was brought to the fact that the tip of the oral temperature probe was missing.
The prevalence of severe obesity, defined as a body mass index (BMI)> 35kg/m2, has been increasing in the adolescent population (1). Affecting between 4-6% of all youth, many of these adolescents and young adults with severe obesity also suffer from co-morbidities such as type 2 diabetes, hypertension, obstructive sleep apnea, and arthritis (2,3). The benefits of bariatric surgery and subsequent long-term weight loss have been extensively reviewed in adults (4,5), and more recently adolescent outcomes have been reported by the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study (6-8).