The Effect of Obesity, Bariatric Surgery, and Operative Time on Abdominal Body Contouring Outcomes

2021 ◽  
Author(s):  
Vasileios Vasilakis ◽  
Jeffrey L Lisiecki ◽  
Bill G Kortesis ◽  
Gaurav Bharti ◽  
Joseph P Hunstad
Keyword(s):  
Bariatric Surgery ◽  
Operative Time ◽  
Univariate Analysis ◽  
Body Contouring ◽  
Individual Risk ◽  
Wound Complications ◽  
Complication Rates ◽  
Procedure Time ◽  
Body Contouring Surgery ◽  
History Of

Abstract Background Abdominal body contouring procedures are associated with the highest rates of complications among all aesthetic procedures. Patient selection and optimization of surgical variables are crucial in reducing morbidity and complications. Objectives The purpose of this single-institution study was to assess complication rates, and to evaluate BMI, operative time, and history of bariatric surgery as individual risk factors in abdominal body contouring surgery. Methods A retrospective chart review was performed of all patients who underwent abdominoplasty, circumferential lower body lift, fleur-de-lis panniculectomy (FDL), and circumferential FDL between August 2014 and February 2020. Endpoints were the incidence of venous thromboembolism, bleeding events, seroma, infection, wound complications, and reoperations. Univariate statistical analysis and multivariate logistic regressions were performed. Covariates in the multivariate logistic regression were BMI, procedure time, and history of bariatric surgery. Results A total of 632 patients were included in the study. Univariate analysis revealed that longer procedure time was associated with infection (P = 0.0008), seroma (P = 0.002), necrosis/dehiscence (P = 0.01), and reoperation (P = 0.002). These associations persisted following multivariate analyses. There was a trend toward history of bariatric surgery being associated with minor reoperation (P = 0.054). No significant increase in the incidence of major reoperation was found in association with overweight or obese patient habitus, history of bariatric surgery, or prolonged procedure time. BMI was not found to be an individual risk factor for morbidity in this patient population. Conclusions In abdominal body contouring surgery, surgery lasting longer than 6 hours is associated with higher incidence of seroma and infectious complications, as well as higher rates of minor reoperation. Level of Evidence: 4

scholarly journals O49 COMPARING OUTCOMES BETWEEN MINIMALLY INVASIVE AND OPEN INGUINAL HERNIA REPAIR

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Michael Katzen ◽  
Sullivan Ayuso ◽  
Bola Aladegbami ◽  
Raageswari Nayak ◽  
Paul Colavita ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Minimally Invasive ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Operative Time ◽  
Univariate Analysis ◽  
Wound Complications ◽  
History Of ◽  
Open Inguinal Hernia Repair

Abstract Aim Prospective evaluation comparing outcomes between laparoscopic (LIHR), robotic (RIHR), and open inguinal hernia repair (OIHR). Material and Methods Prospective institutional data comparison of patients undergoing inguinal hernia repair from 1999–2020 was performed. Patients with chronic pain or infection were excluded. Standard statistical methods were used and univariate analysis was performed between LIHR, RIHR, and OIHR groups. Results 3,300 repairs were performed: 1,970 LIHR (597-bilateral), 127 RIHR (25-bilateral), and 538 OIHR (43-bilateral). LIHR and RIHR patients were younger (55.4±14.8vs59.0±13.7vs 65.0±13.7years;p<0.01), with lower BMI (26.6±6.5vs28.9±20.3vs31.8±7.6kg/m2; p<0.01), fewer overall (2.7±1.9 vs 2.7±2.2vs3.7±2.5; p < 0.01) and cardiac (0.2% vs 0% vs 2.6%; p<0.01) comorbidities, and fewer patients had diabetes (5.2%vs4.6%vs10.9%; p<0.01). OIHR had the highest rate of recurrent hernias (21.2%vs11.2%vs30.9%; p<0.01). History of smoking was less in LIHR (13.9%vs30.9%vs19.5%%; p<0.01). Mesh was used in 99.5% of cases; synthetic was used in all minimally invasive cases and 98.4% of OIHR, with biologic mesh in 1.0% of OIHR due to bowel resection during the operation. Operative time was shortest in LIHR followed by open (86.5±39.6vs109.0±56.8vs92.6±55.2 min; p<0.01). Wound complications were more frequent in OIHR (0.8%vs0.7%vs3.8%; p<0.01). Admission was more common after open repair (2.2%vs2.7%vs5.7%; p<0.01) with a trend to less readmission following LIHR (1.0%vs2.0%vs2.3%; p=0.06). There were few recurrences overall (0.7%vs0.7%vs1.3%; p=0.40) with mean follow-up time 21.1±22.4 months. Conclusions LIHR, RIHR, and OIHR were performed with low overall morbidity and complications. Recurrent hernias and cardiac patients were most often repaired open, which more frequent admission and had higher wound morbidity. RIHR had longer OR times with no improvement overall outcomes.

Body Contouring Surgery after Bariatric Surgery

2016 ◽  
pp. 713-721 ◽  
Author(s):  
Mark Soldin ◽  
Charles Jack Bain ◽  
Maleeha Mughal
Keyword(s):  
Bariatric Surgery ◽  
Body Contouring ◽  
Body Contouring Surgery

Body Contouring Surgery Improves Weight Loss after Bariatric Surgery: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Rawan ElAbd ◽  
Osama A. Samargandi ◽  
Khalifa AlGhanim ◽  
Salma Alhamad ◽  
Sulaiman Almazeedi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Weight Loss ◽  
Meta Analysis ◽  
Body Contouring ◽  
Body Contouring Surgery

Body Contouring Surgery after Bariatric Surgery

2014 ◽  
Vol 133 (6) ◽  
pp. 776e-782e ◽  
Author(s):  
Arash Azin ◽  
Carrol Zhou ◽  
Timothy Jackson ◽  
Stephanie Cassin ◽  
Sanjeev Sockalingam ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Contouring ◽  
Body Contouring Surgery

Body Contouring Surgery following Roux-En-Y Gastric Bypass in the Longitudinal Assessment of Bariatric Surgery-2 Cohort

2015 ◽  
Vol 11 (6) ◽  
pp. S50
Author(s):  
Kristine Steffen ◽  
James Mitchell ◽  
Anita Courcoulas ◽  
J. Peter Rubin ◽  
Jo Ellison ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Body Contouring ◽  
Longitudinal Assessment ◽  
Body Contouring Surgery

scholarly journals The effect of body contouring surgery on weight loss maintenance following bariatric surgery

2016 ◽  
Vol 36 ◽  
pp. S40
Author(s):  
M. Greenfield ◽  
O. Smith ◽  
N. Hachach-Haram ◽  
N. Bystrzonowski ◽  
A. Pucci ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Body Contouring ◽  
Weight Loss Maintenance ◽  
Body Contouring Surgery

Single Incision Laparoscopic Cholecystectomy Performed via the “Marionette” Technique Shows Equivalence in Outcome and Cost to Standard Four Port Laparoscopic Cholecystectomy in a Selected Patient Population

2015 ◽  
Vol 81 (10) ◽  
pp. 1015-1020 ◽  
Author(s):  
Maryam N. Saidy ◽  
Sunal S. Patel ◽  
Mark W. Choi ◽  
Mohammed Al-Temimi ◽  
Deron J. Tessier
Keyword(s):  
Multivariate Analysis ◽  
Laparoscopic Cholecystectomy ◽  
Blood Loss ◽  
Hospital Stay ◽  
Operative Time ◽  
Single Incision ◽  
Univariate Analysis ◽  
Operating Time ◽  
Complication Rates ◽  
Single Incision Laparoscopic Cholecystectomy

The aim of our study is to compare single incision laparoscopic cholecystectomy (SILC) performed using the “marionette” technique (m-SILC), to the standard four-port technique [four-port laparoscopic cholecystectomy (4PLC)]. Patient information was extracted from a prospectively maintained database (n = 188). Our primary endpoint was operative costs (determined by operating time and instruments used). Secondary endpoints were length of stay, operative time, blood loss, and postoperative complication rates. Univariate and adjusted multivariate analysis was used to compare the outcomes. There were a total of 188 patients for this study. Gender, body mass index, American Society of Anesthesiologists class, and resident participation were similar. Patients undergoing m-SILC were younger (43.8 vs 49.8 years old), less likely to have cholangiogram (32% vs 54%), and were more likely to undergo cholecystectomy for chronic cholecystitis (73.3% vs 52%). In univariate analysis, cholecystectomy performed by the “marionette method” as compared with the 4PLC was associated with shorter operative time (67 vs 59 minutes respectively) and shorter hospital stay (1.2 vs 2.08 days respectively). In multivariate analysis, SILC was associated with shorter hospital stay and comparable operative time, blood loss, and postoperative complications. Instrumentation cost was less in SILC (by $94). SILC done by an experienced surgeon with the “marionette” technique on a carefully selected population shows a statistically significant cost benefit while maintaining clinically comparable outcomes to the standard 4PLC.

Abstract P168: Predictors Of Htn Remission Post-bariatric Surgery: A Contemporary Analysis

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Carlos Manuel Romero ◽  
Lauren Tragesser ◽  
Abdullah Haddad ◽  
Kaitlyn Ibrahim ◽  
Rohit Soans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Univariate Analysis ◽  
P Value ◽  
Post Operation ◽  
Major Predictor ◽  
History Of ◽  
Baseline Characteristics ◽  
Post Bariatric Surgery

Introduction: The effect of bariatric surgery on improvement and remission of hypertension (HTN) is well documented. However, the factors that influence HTN remission in this population are poorly understood and have not been investigated in over a decade. We aim to describe predictors of HTN remission post-bariatric surgery in a contemporary patient population. Methods: All patients who underwent sleeve gastrectomy or Roux-en-Y gastric bypass from January 2014 to December 2018 at an urban academic institution were included in the analysis. Blood pressure (BP) was recorded pre-operatively, 6-month post operation, and 12-month post operation. HTN was defined as BP ≥ 140/90 or patients on anti-hypertensive medications. Remission was defined as BP < 140/90 off all blood pressure medications. Baseline characteristics of patients with and without HTN remission were described. Logistic regression analysis was performed to assess indicators of HTN remission. A p-value of 0.05 was used for all statistical analyses. Results: Among 844 patients who underwent bariatric surgery, 497 (58.9%) patients had HTN. Among HTN patients 167 (33.6%) had remission at 6 months and 126 (25.4%) had remission at 12 months. The major predictor of HTN remission on multivariate analysis was number of pre-operative medications at 6 months (OR 2.5, 95% CI 2.03 to 3.29) and 12 months (OR 2.6, 95% CI 1.99 to 3.56). Major predictors on univariate analysis at 12 months were CVA (OR 4.3, 95% CI 1.40 to 12.47) and HLD (OR 1.76, 95% CI 1.27 to 2.45). Conclusion: Number of pre-operative medications is a top predictor of HTN remission. HLD and history of stroke may be present in patients who are less likely to have HTN remission.

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