scholarly journals Ventral hernia surgery in morbidly obese patients, immediate or after bariatric surgery preparation: Results of a case-matched study

2019 ◽  
Vol 15 (1) ◽  
pp. 83-88 ◽  
Author(s):  
Marie-Maëlle Chandeze ◽  
David Moszkowicz ◽  
Alain Beauchet ◽  
Karina Vychnevskaia ◽  
Frédérique Peschaud ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Ventral Hernia ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Hernia Surgery ◽  
Matched Study

scholarly journals P008 SYNCHRONOUS SURGICAL TREATMENT OF MORBID OBESITY AND COMPLEX VENTRAL HERNIA AFTER PROGRESSIVE PNEUMOPERITONEUM AND BOTULINUM TOXIN A INJECTION

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Camillo Leonardo Bertoglio ◽  
Lorenzo Morini ◽  
Gisella Barone ◽  
Marianna Maspero ◽  
Bruno Alampi ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Botulinum Toxin ◽  
Hernia Repair ◽  
Abdominal Wall ◽  
Ventral Hernia ◽  
Ventral Hernia Repair ◽  
Botulinum Toxin A ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Toxin A

Abstract Aim the worldwide increase in morbidly obese patients with complex hernia raises controversies in the choice of the appropriate treatment timing: synchronous bariatric and abdominal wall surgery versus delayed abdominal wall surgery. We report an innovative tailored surgical treatment carried out at our Institution. Material and Methods the approach provided the injection, six weeks before surgery, of 500 international units of botulinum toxin A on either side of the large abdominal wall muscles. Four weeks before surgery pneumoperitoneum was inducted and out-patient daily sessions of progressive insufflation with ambient air were then carried out. Surgery was scheduled 48 days after botulinum injection. Sleeve gastrectomy and simultaneous posterior component separation with transversus abdominis release were performed. Two prosthetic meshes were placed sublay. Results Postoperative superficial surgical site infection was successfully treated with negative pressure wound therapy. At one year follow up no hernia recurrence was recorded while total body weight loss was 31%. Conclusions a delay in ventral hernia repair could worsen quality of life of morbidly obese patients. In such high risk patients, the choice of the best surgical strategy remains controversial. There is great concern in performing bariatric surgery simultaneously to hernia repair, although there is lack of evidence on which is the ideal treatment modality. Synchronous bariatric surgery and complex ventral hernia repair should be approached in high volume centres where a consolidated experience of multidisciplinary team-work is available. Combined botulinum toxin A and preoperative progressive pneumoperitoneum administration allow for a safe resolution of loss of domain.

scholarly journals The Effect of Bariatric Surgery Volume on General Surgery Outcomes for Morbidly Obese Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Katheryn Hope Wilkinson ◽  
Ruizhe Wu ◽  
Aniko Szabo ◽  
Rana Higgins ◽  
Jon Gould ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Hernia Repair ◽  
Ventral Hernia ◽  
General Surgery ◽  
Ventral Hernia Repair ◽  
High Volume ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Procedure Volume

Introduction. Bariatric surgery performed at high volume centers decreases length of stay, cost, and morbidity and mortality. The effect of a high volume of bariatric surgery procedures on outcomes may extend not just to bariatric surgery but to any general surgical procedure in morbidly obese patients. We hypothesized that patients with morbid obesity (body mass index >40 kg/m2) undergoing common, nonbariatric general surgery would have decreased morbidity and mortality at centers performing high volumes of bariatric surgery. Methods. The 2016 National Inpatient Sample (NIS) was used to identify the number of laparoscopic gastric bypass and sleeve gastrectomy performed at each hospital. Hospitals were classified as high volume bariatric hospitals (HVBH) ≥10 reported cases (50 actual)/year or low volume bariatric hospitals (LVBH) <10 reported cases (50 actual)/year, as NIS reports a 20% sample of actual cases. Patients with morbid obesity undergoing laparoscopic or open appendectomy, cholecystectomy, or ventral hernia repair were included for analysis. Propensity scores were developed based on available demographics, comorbidities, and hospital procedure volume. Postoperative complications during the index hospital admission, determined by ICD-10 code, were compared using inverse propensity weights. Differences were considered significant with a p value of <0.05. Results. The total number of general surgery patient cases analyzed was 14,028 from 2,482 hospitals, representing 70,140 admissions. The cohort of patients undergoing operations treated at HVBH were younger ( p = 0.03 ) with higher rates of COPD ( p = 0.04 ). Patients at LVBH had higher rates of nicotine dependence ( p = 0.0001 ) and obstructive sleep apnea ( p < 0.001 ). On propensity-weighted analysis adjusting for preoperative comorbidities and hospital procedure volume, there were significantly higher rates of multiple postprocedure complications at LVBH, specifically, postprocedure respiratory failure for patients undergoing elective laparoscopic cholecystectomy, elective ventral hernia repair with mesh and appendectomy. Conclusion. Patients with morbid obesity may have an advantage in having general surgery procedures at HVBH. HVBH may have a volume-outcomes relationship where the hospital and staff familiarity with the management principles required to minimize the postoperative risk associated with morbid obesity and improve patient outcomes.

Improvement in Obstructive Sleep Apnea (OSA) in Super Morbidly Obese Patients After Bariatric Surgery

2020 ◽  
Vol 103 (8) ◽  
pp. 725-728
Keyword(s):  
Bariatric Surgery ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Lifestyle Modification ◽  
Apnea Hypopnea Index ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obstructive Sleep ◽  
Objective Evidence

Background: Lifestyle modification is the mainstay therapy for obese patients with obstructive sleep apnea (OSA). However, most of these patients are unable to lose the necessary weight, and bariatric surgery (BS) has been proven to be an effective modality in selected cases. Objective: To provide objective evidence that BS can improve OSA severity. Materials and Methods: A prospective study was conducted in super morbidly obese patients (body mass index [BMI] greater than 40 kg/m² or BMI greater than 35 kg/m² with uncontrolled comorbidities) scheduled for BS. Polysomnography (PSG) was performed for preoperative assessment and OSA was treated accordingly. After successful surgery, patients were invited to perform follow-up PSG at 3, 6, and 12 months. Results: Twenty-four patients with a mean age of 35.0±14.0 years were enrolled. After a mean follow-up period of 7.8±3.4 months, the mean BMI, Epworth sleepiness scale (ESS), and apnea-hypopnea index (AHI) significantly decreased from 51.6±8.7 to 38.2±6.8 kg/m² (p<0.001), from 8.7±5.9 to 4.7±3.5 (p=0.003), and from 87.6±38.9 to 28.5±21.5 events/hour (p<0.001), respectively. Conclusion: BS was shown to dramatically improve clinical and sleep parameters in super morbidly obese patients. Keywords: Morbid obesity, Bariatric surgery, Obstructive sleep apnea (OSA)

scholarly journals Endovascular Bariatric Surgery as Novel Minimally Invasive Technique for Weight Management in the Morbidly Obese: Review of the Literature

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2541
Author(s):  
Giuseppe Massimo Sangiorgi ◽  
Alberto Cereda ◽  
Nicola Porchetta ◽  
Daniela Benedetto ◽  
Andrea Matteucci ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Minimally Invasive ◽  
Weight Management ◽  
World Health ◽  
Invasive Technique ◽  
Morbidly Obese ◽  
World Population ◽  
Obese Patients ◽  
The World ◽  
Open Bariatric Surgery

Nowadays, obesity represents one of the most unresolved global pandemics, posing a critical health issue in developed countries. According to the World Health Organization, its prevalence has tripled since 1975, reaching a prevalence of 13% of the world population in 2016. Indeed, as obesity increases worldwide, novel strategies to fight this condition are of the utmost importance to reduce obese-related morbidity and overall mortality related to its complications. Early experimental and initial clinical data have suggested that endovascular bariatric surgery (EBS) may be a promising technique to reduce weight and hormonal imbalance in the obese population. Compared to open bariatric surgery and minimally invasive surgery (MIS), EBS is much less invasive, well tolerated, with a shorter recovery time, and is probably cost-saving. However, there are still several technical aspects to investigate before EBS can be routinely offered to all obese patients. Further prospective studies and eventually a randomized trial comparing open bariatric surgery vs. EBS are needed, powered for clinically relevant outcomes, and with adequate follow-up. Yet, EBS may already appear as an appealing alternative treatment for weight management and cardiovascular prevention in morbidly obese patients at high surgical risk.

No effect of different bariatric surgery procedures on LINE-1 DNA methylation in diabetic and nondiabetic morbidly obese patients

2017 ◽  
Vol 13 (3) ◽  
pp. 442-450 ◽  
Author(s):  
G.M. Martín-Núñez ◽  
A. Cabrera-Mulero ◽  
J. Alcaide-Torres ◽  
E. García-Fuentes ◽  
F.J. Tinahones ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Dna Methylation ◽  
Morbidly Obese ◽  
Obese Patients ◽  
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