Study of the Rate of Excess Weight Loss after Laparoscopic Sleeve Gastrectomy and Laparoscopic Gastric Plication in Morbidly Obese Patients = دراسة معدل فقد الوزن الزائد بعد العمليات الجراحية من نوعية تكميم المعدة وطيها باستخدام المنظار الجراحي لمرضى السمنة المفرطة

2017 ◽  
Vol 46 (1) ◽  
pp. 297-313
Author(s):  
Kamal Rabi Eid ◽  
Ahmed Salama Sayoh ◽  
Ayman Mahmoud Elwan
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Morbidly Obese ◽  
Gastric Plication ◽  
Obese Patients ◽  
Laparoscopic Gastric Plication

Laparoscopic Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Achieve Comparable Weight Loss at 1 Year

2012 ◽  
Vol 78 (12) ◽  
pp. 1325-1328 ◽  
Author(s):  
Arezou Yaghoubian ◽  
Amy Tolan ◽  
Bruce E. Stabile ◽  
Amy H. Kaji ◽  
Gary Belzberg ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Weight Loss Program ◽  
Excess Weight ◽  
Morbidly Obese ◽  
Preoperative Weight Loss ◽  
Obese Patients ◽  
Laparoscopic Rygb ◽  
Preoperative Weight

Laparoscopic sleeve gastrectomy has gained popularity as a weight loss surgical option for morbidly obese patients. Although initial studies have shown weight loss and comorbidity resolution comparable to those after laparoscopic Roux-en-Y gastric bypass (RYGB), many of these studies are limited by the small patient size. Thus, the purpose of this study was to compare the outcomes of laparoscopic sleeve gastrectomy and laparoscopic RYGB. A retrospective chart review of all morbidly obese patients who underwent laparoscopic RYGB or sleeve gastrectomy between 2007 and 2009 at an HMO hospital was conducted. Data points collected included age, gender, completion of a preoperative weight loss program, initial body mass index (BMI), pre- and postoperative weights, and presence of diabetes mellitus (DM), hypertension (HTN), osteoarthritis, obstructive sleep apnea, and gastroesophageal reflux disease (GERD). Outcomes measures included excess weight loss, resolution of comorbidities, postoperative complications, and mortality. A total of 345 laparoscopic RYGBs and 192 sleeve gastrectomies were performed. On average, the patients who received RYGB were younger (46 vs 48 years, P = 0.05) and had higher BMI (47 vs 43 kg/m2, P < 0.0001). There was a higher incidence of DM in the RYGB group (32 vs 22%, P = 0.01), whereas the incidences of HTN and GERD were similar in both surgical groups. Ninety-three per cent of the patients who underwent RYGB and 90 per cent of the patients who underwent sleeve gastrectomy completed a preoperative weight loss program. The median length of hospital stay for both groups was 3 days. The complication rate in both groups was 9 per cent. The incidence of gastric leak was 1 per cent in both groups. There was only one mortality, which occurred in the RYGB group. The postoperative resolution of DM was comparable in both groups. The RYGB group had greater resolution of HTN (48 vs 34%, P = 0.03) and GERD (73 vs 34%, P < 0.0001). At 12 months, sleeve gastrectomy achieved superior excess weight loss compared with RYGB (72 vs 61%, P = 0.0015). After adjusting for age and BMI, the excess weight loss for RYGB and sleeve gastrectomy was similar at 12 months (t parameter estimate -0.06, P = 0.08). Laparoscopic RYGB and sleeve gastrectomy had comparable postoperative morbidity and mortality rates. At 1 year, sleeve gastrectomy achieved only slightly greater weight loss. The two operations are both legitimate standalone bariatric procedures and their applications need to be based on individual patient characteristics and needs.

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.

Laparoscopic Sleeve Gastrectomy: Outcomes at a Military Training Center

2010 ◽  
Vol 76 (8) ◽  
pp. 835-840
Author(s):  
Robert D. Rice ◽  
Todd E. Simon ◽  
Jason M. Seery ◽  
James D. Frizzi ◽  
Farah A. Husain ◽  
...  
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Military Training ◽  
Excess Weight ◽  
Bariatric Procedure ◽  
Outcome Analysis ◽  
Long Term Outcome ◽  
The Mean

Laparoscopic sleeve gastrectomy (LSG) has gained support as a single-staged and stand-alone bariatric procedure. Reports of excess weight loss of 35 to 83 per cent, reduction in comorbidities, and decreased operative morbidity have garnered support for LSG. This study represents an initial outcome analysis of LSG performed solely at a military treatment center. This study is a retrospective analysis of all patients receiving LSG at Dwight D. Eisenhower Army Medical Center from September 2007 to December 2009. The patients were planned for a stand-alone procedure. One hundred and fifteen patients received LSG over this time period with a mean body mass index of 45.5 ± 6.2 (range 35.1-58.3). The average age was 47.4 ± 12.5 years. Diabetes mellitus was seen in 47 per cent and 68 per cent of patients had hypertension. The mean and median length of operation was 124 ± 48 and 115.5 minutes. The mean percentage of excess weight loss was 16.6 ± 6.40 per cent at 1 month, 31.5 ± 7.6 per cent at 3 months, 41.2 ± 13.9 per cent at 6 months, and 53.7 ± 12.5 per cent at 1 year from surgery. One or more of patient's preoperative diabetic or hypertensive medications were improved postoperatively in 18.7 per cent and 16.3 per cent, respectively. Incidence of major complications occurred in 4.35 per cent of patients in this study to include four leaks (3.4%), one death (0.87%), and 10 readmissions. Midterm analysis of outcomes related to LSG as a single-stage bariatric procedure is promising as long-term outcome data is collected; the efficacy of this procedure as a sole bariatric procedure will continue to be borne out.

The Effects of Bougie Caliber on Leaks and Excess Weight Loss Following Laparoscopic Sleeve Gastrectomy. Is There an Ideal Bougie Size?

2013 ◽  
Vol 23 (10) ◽  
pp. 1685-1691 ◽  
Author(s):  
Jonathan B. Yuval ◽  
Yoav Mintz ◽  
Matan J. Cohen ◽  
Avraham I. Rivkind ◽  
Ram Elazary
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Bougie Size

scholarly journals Laparoscopic Gastric Plication for the Treatment of Morbid Obesity: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Michael Kourkoulos ◽  
Emmanouil Giorgakis ◽  
Charalampos Kokkinos ◽  
Theodoros Mavromatis ◽  
John Griniatsos ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Current Literature ◽  
Case Reports ◽  
Low Cost ◽  
Prosthetic Material ◽  
Gastric Plication ◽  
Laparoscopic Gastric Plication

Introduction. Laparoscopic greater curvature plication is an operation that is gaining ground in the treatment of morbid obesity, as it appears to replicate the results of laparoscopic sleeve gastrectomy with fewer complications.Aim. Review of current literature, especially results on weight loss and complications.Method. 11 (eleven) published articles on laparoscopic gastric plication, of which 1 preclinical study, 8 prospective studies for a total of 521 patients and 2 case reports of unusual complications.Results. Reported Paracentage of EWL in all studies is comparable to Laparoscopic Sleeve Gastrectomy (around 50% in 6 months, 60–65% in 12 months, 60–65% in 24 months) and total complication rate is at 15,1% with minor complications in 10,7%, major complications in 4,4%. Reoperation rate was 3%, conversion rate was 0,2%, and mortality was zero.Conclusion. Current literature on gastric plication and its modifications is limited and sketchy at times. Low cost, short hospital stay, absence of prosthetic material, and reversibility make it an attractive option. Initial data show that LGCP is effective for short- and medium-term weight loss, complication and reoperation rates are low, and GERD symptoms are unaffected. More data is required, and randomized control trials must be completed in order to reach safe conclusions.

scholarly journals Intragastric balloons in high-risk obese patients in a Brazilian center: initial experience

2018 ◽  
Vol 45 (1) ◽  
Author(s):  
ALANA COSTA BORGES ◽  
PAULO CÉSAR ALMEIDA ◽  
STELLA M. T. FURLANI ◽  
MARCELO DE SOUSA CURY ◽  
SHANTANU GAUR
Keyword(s):  
Weight Loss ◽  
High Risk ◽  
Intragastric Balloon ◽  
Excess Weight Loss ◽  
Excess Weight ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Initial Weight Loss ◽  
Intragastric Balloons ◽  
Student’S T

ABSTRACT Objective: to assess the short-term efficacy, tolerance and complications in high-risk morbidly obese patients treated with an intragastric balloon as a bridge for surgery. Methods: we conducted a post-hoc analysis study in a Brazilian teaching hospital from 2010 to 2014, with 23 adult patients with a BMI of 48kg/m2, who received a single intragastric air or liquid balloon. We defined efficacy as 10% excess weight loss, and complications, as adverse events consequent to the intragastric balloon diagnosed after the initial accommodative period. We expressed the anthropometric results as means ± standard deviation, comparing the groups with paired T / Student’s T tests, when appropriate, with p<0.05 considered statistically significant. Results: the balloons were effective in 91.3% of the patients, remained in situ for an average of 5.5 months and most of them (65.2%) were air-filled, with a mean excess weight loss of 23.7kg±9.7 (excess weight loss 21.7%±8.9) and mean BMI reduction of 8.3kg/m2±3.3. Complications (17.3%) included abdominal discomfort, balloon deflation and late intolerance, without severe cases. Most of the participants (82.7%) did not experience adverse effects. We removed the intragastric balloons in time, without intercurrences, and 52.2% of these patients underwent bariatric surgery within one month. Conclusion: in our center, intragastric balloons can be successfully used as an initial weight loss procedure, with good tolerance and acceptable complications rates.

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