scholarly journals Outcomes of Laparoscopic Gastric Greater Curvature Plication in Morbidly Obese Patients

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
N. Khidir ◽  
M. Al Dhaheri ◽  
W. El Ansari ◽  
M. Al Kuwari ◽  
D. Sargsyan ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Weight Regain ◽  
Gastric Pouch ◽  
Future Research ◽  
Morbidly Obese ◽  
Gastric Plication ◽  
Obese Patients ◽  
Pouch Size ◽  
Greater Curvature ◽  
Greater Curvature Plication

Background. Laparoscopic gastric greater curvature plication (LGGCP) is a restrictive bariatric procedure without gastrectomy. However, limited literature on effectiveness of gastric plication exists. Objectives. We assessed LGGCP’s efficacy, effects on associated comorbidities, safety and the rate of complications, and patient satisfaction with LGGCP’s outcomes among morbidly obese patients. Method. Analysis of retrospectively data collected from medical records of 26 patients who had undergone LGGCP at Hamad General Hospital, Qatar, during 2011-2012. Results. Most patients (92%) were Qatari nationals. The sample’s mean age was 35.1 years. Mean duration of hospital stay was 3.9±1.2 days. Mean preoperative BMI was 40.7 kg/m2 that decreased at 2 years to 34.6 kg/m2. LGGCP’s effects on comorbidities were such that 7.6% of patients experienced resolutions of their comorbidities. There were no mortality or postoperative complications that required reoperation. Six patients (23%) were satisfied with the LGGCP’s outcomes while 10 patients (38.5%) underwent sleeve gastrectomy subsequently. Conclusion. LGGCP had acceptable short term weight loss results, exhibited almost no postoperative complications, and improved patients’ comorbidities. Despite the durability of the gastric fold, some patients regained weight. Future research may assess the possibility of an increase in the gastric pouch size postplication associated with weight regain.

scholarly journals Laparoscopic gastric plication: towards standardization

2017 ◽  
Vol 5 (1) ◽  
pp. 221
Author(s):  
Ahmed Abdel Monem Ibrahim ◽  
Ahmed Elgeidie ◽  
Nabil Gadelhak
Keyword(s):  
Weight Regain ◽  
Excess Weight Loss ◽  
Mini Gastric Bypass ◽  
Morbidly Obese ◽  
Gastric Plication ◽  
Obese Patients ◽  
Future Studies ◽  
Laparoscopic Gastric Plication ◽  
Good Reputation

Background: Laparoscopic gastric plication (LGP) is a restrictive bariatric procedure which was found to be safe, effective and economic as well. However, it hasn't a good reputation among some bariatric surgeons due to some reasons; the most important of them is lack of standardization.  Objective of the present stud was to study propose a standardized technique for LGP aiming at a better outcome.  Setting. Settings: University-affiliated hospital.Methods: This is a retrospective analysis of patients who underwent LGP by the proposed technique., using seromuscular bites with non-absorbable thread, adoption of the four-bite technique, and calibration using bougie.Results: Eighty-eight consecutive morbidly obese patients had been operated by the proposed standardized technique of LGP between March 2010 and September 2014. There were 19 men and 69 women, with a mean age of 30.3 years and a mean BMI of 36.7kg/m2 (range 32-51kg/m2). The most frequently reported complication was prolonged early postoperative nausea/vomiting occurred in 5 of 88 (5.7%) patients. Weight regain was reported in one patient who was treated with conversion of LGP to laparoscopic mini-gastric bypass. Hospital stay was prolonged for a mean of 6.0 (3 -10 days). Postoperative follow-up period ranged from 2 to 38 months with a mean of 15 months. Percentage of excess weight loss was 38.2%, 52.0%, and 63.1% at 3, 6, and 12 months, respectively.Conclusions: The proposed technique of LGP would help in standardization of the procedure in order to improve the outcome; however, the clinical application of this proposed standardized technique should be tested by future studies.

scholarly journals Total hip arthroplasty through the direct anterior approach in morbidly obese patients

2022 ◽  
Vol 3 (1) ◽  
pp. 4-11
Author(s):  
Chrysoula Argyrou ◽  
Dimitrios Tzefronis ◽  
Michail Sarantis ◽  
Konstantinos Kateros ◽  
Lazaros Poultsides ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Total Hip Arthroplasty ◽  
Anterior Approach ◽  
Operating Time ◽  
Direct Anterior Approach ◽  
Obese Group ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Set Up ◽  
Outcome Tool

Aims There is evidence that morbidly obese patients have more intra- and postoperative complications and poorer outcomes when undergoing total hip arthroplasty (THA) with the direct anterior approach (DAA). The aim of this study was to determine the efficacy of DAA for THA, and compare the complications and outcomes of morbidly obese patients with nonobese patients. Methods Morbidly obese patients (n = 86), with BMI ≥ 40 kg/m2 who underwent DAA THA at our institution between September 2010 and December 2017, were matched to 172 patients with BMI < 30 kg/m2. Data regarding demographics, set-up and operating time, blood loss, radiological assessment, Harris Hip Score (HHS), International Hip Outcome Tool (12-items), reoperation rate, and complications at two years postoperatively were retrospectively analyzed. Results No significant differences in blood loss, intra- and postoperative complications, or implant position were observed between the two groups. Superficial wound infection rate was higher in the obese group (8.1%) compared to the nonobese group (1.2%) (p = 0.007) and relative risk of reoperation was 2.59 (95% confidence interval 0.68 to 9.91). One periprosthetic joint infection was reported in the obese group. Set-up time in the operating table and mean operating time were higher in morbidly obese patients. Functional outcomes and patient-related outcome measurements were superior in the obese group (mean increase of HHS was 52.19 (SD 5.95) vs 45.1 (SD 4.42); p < 0.001), and mean increase of International Hip Outcome Tool (12-items) was 56.8 (SD 8.88) versus 55.2 (SD 5.85); p = 0.041). Conclusion Our results suggest that THA in morbidly obese patients can be safely and effectively performed via the DAA by experienced surgeons. Cite this article: Bone Jt Open 2022;3(1):4–11.

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