scholarly journals Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Faryal G. Afridi ◽  
Morgan Johnson ◽  
Kelsey A. Musgrove ◽  
Salim Abunnaja ◽  
Lawrence E. Tabone ◽  
...  

Introduction. The Angelchik prosthesis (AP) is a historic antireflux device which consists of a C-shaped silicone ring placed around the gastroesophageal junction (GEJ) and secured by Dacron tape. We present a rare experience with an AP and its impact on bariatric surgical outcomes. Case. Our patient is a 66-year-old woman who had an open antireflux procedure with an AP in 1987. She presented to a bariatric clinic for consideration of bariatric surgery for the treatment of morbid obesity and associated comorbidities. She also reported significant problems with reflux and dysphagia. After an appropriate work-up, an AP was identified at her GEJ. She was taken to the operating room for laparoscopic removal with planned interval laparoscopic sleeve gastrectomy. Intraoperatively, the AP was identified around the GEJ; after extensive adhesiolysis, the prosthesis was removed. Postoperatively, in order to determine if the AP had caused any lasting esophageal motility problems, the patient underwent a high-resolution esophageal manometry which demonstrated normal esophageal motility. Interval laparoscopic sleeve gastrectomy was performed safely 9 weeks later. Conclusion. Although rarely used, it is still possible to encounter an Angelchik prosthesis in practice. General and bariatric surgeons need to be aware of this rare device and understand how to manage its related complications.

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hidetaka Ichikawa ◽  
Hirofumi Imoto ◽  
Naoki Tanaka ◽  
Hiroaki Musha ◽  
Shojiro Sawada ◽  
...  

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.


2021 ◽  
Vol 6 (1) ◽  
pp. e1-e1
Author(s):  
Emilio Manno ◽  

Laparoscopic sleeve gastrectomy (LSG) is currently the most performed bariatric procedure in the world. The 4th International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global registry report (2014-18) estimates 87,015 procedures, equal to 45.9% of all bariatric procedures. Initially performed as the first step of the duodenals witch (biliopancreatic diversion with duodenal switch (BPD-DS)), a very complex malabsorptive procedure invented by a Canadian Surgeon P. Marceau as an evolution of the BPD, invented by N. Scopinaro, an Italian surgeon, LSG established itself in the early 2000s as a stand alone procedure, especially following the observations of Michael Gagner, pioneer of bariatric surgery. Over the years LSG has grown rapidly. The reasons for this popularity are the relative technical simplicity compared to other procedures, efficacy, good quality. For these reasons there has been a real explosion of bariatric surgery: many surgeons, driven by the relative simplicity of the procedure (longitudinal gastrectomy on the guide of a probe), begun to propose this procedure. So is LSG really an effective simple procedure that is good for all patients? Absolutely not. Performing a longitudinal gastrectomy can be simple; performing a good LSG is not.


2013 ◽  
Vol 37 ◽  
pp. S253-S254
Author(s):  
Justin Peddle ◽  
Kendra Lester ◽  
Carla Dillon ◽  
Deborah M. Gregory ◽  
Lauire Twells

2020 ◽  
Vol 8 ◽  
pp. 2050313X2095300 ◽  
Author(s):  
Suzanna Connick Jamison ◽  
Kelley Aheron

A patient with morbid obesity and several psychiatric comorbidities underwent laparoscopic sleeve gastrectomy and experienced success with weight loss. However, she experienced lightheadedness, nausea, and a fall and was admitted to the hospital for encephalopathy due to lithium toxicity. The pharmacokinetics of lithium is altered following bariatric surgery. Due to these factors, adjustments were made to the patient’s lithium therapy, her levels were subsequently reduced into the therapeutic range, and she continued with no further issues. Mechanisms of lithium toxicity following bariatric surgery and a monitoring protocol to prevent toxicity are discussed.


Author(s):  
Matteo Uccelli ◽  
Simone Targa ◽  
Giovanni Carlo Cesana ◽  
Alberto Oldani ◽  
Francesca Ciccarese ◽  
...  

2016 ◽  
Vol 82 (5) ◽  
pp. 448-455
Author(s):  
Christopher W. Mangieri ◽  
Matthew A. Strode ◽  
William E. Sherman ◽  
Matthew L. Pierotti ◽  
Byron J. Faler ◽  
...  

Laparoscopic sleeve gastrectomy (LSG) is a recent addition to the bariatric surgery armamentarium. It has been demonstrated to be an efficacious stand-alone bariatric procedure in regard to weight loss. This study evaluates the progress of our initial experience with LSG. Retrospective review of prospective data from 2008 to 2010. Compared data between our first operative year of experience with LSG (2008) and our third year of experience (2010). Data compared for up to three years postoperatively. End points were percentage of excess body weight loss (%EWL) and percentage of excess body mass index loss (%EBL). Institutional improvement in %EWL and %EBL rates as our collective experience increased with LSG. Mean increase in %EWL of 14 per cent and mean increase of %EBL of 22 per cent. In our first year performing LSG the institutional weight loss was <50 per cent EWL, which is often cited as a benchmark level for “success” after bariatric surgery. By our third year of experience with LSG we achieved an institutional weight loss >50 per cent EWL. Institutional improvement in weight loss results with LSG as the collective experience increased. Several factors could have contributed to this observation to include a surgical men-torship program and the institution of formal nutritional education. This study demonstrates that institutional experience is a significant factor in weight loss results with LSG.


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