scholarly journals ROUTINE USE OF V-LOCK® SUTURE FOR BARIATRIC ANASTOMOSIS IS SAFE: COMPARATIVE RESULTS FROM CONSECUTIVE CASE SERIES

2019 ◽  
Vol 32 (3) ◽  
Author(s):  
Claudia BURES ◽  
Philippa SEIKA ◽  
Christian DENECKE ◽  
Johann PRATSCHKE ◽  
Ricardo ZORRON
Keyword(s):  
Gastric Bypass ◽  
Laparoscopic Gastric Bypass ◽  
Operative Time ◽  
Case Series ◽  
Barbed Suture ◽  
Gastrojejunal Anastomosis ◽  
Morbidly Obese ◽  
Group I ◽  
Suture Group ◽  
Group Ii

ABSTRACT Background: In high-income countries, morbid obesity is a growing health problem that has already reached epidemic proportions. When performing a laparoscopic gastric bypass several operative methods exist. Aim: To describe the institutional experience using a knotless unidirectional barbed suture (V-Loc 180/Covidien, Mansfield, MA) to create a hand-sewn gastrojejunostomy (GJ) and jejunojejunostomy (JJ) during bariatric surgery. Methods: Evaluation of a case series of 87 morbidly obese patients who underwent laparoscopic gastric bypass with a hand-sewn gastrojejunostomy (GJA) and jejunojejunostomy (JJA) between 01/2015 and 06/2017. The patients were divided into two groups: in group I, GJA und JJA sutures were performed using the knotless unidirectional barbed suture; in group II, GJA and JJA were sutured with resorbable multifilament thread (Vicryl® 3/0 Ethicon, Livingstone, UK). The recorded data on gender, age, BMI, ASA score, operative time, postoperative morbidity, length of hospital stay, and reoperation, were analyzed and compared. Results: All procedures were completed laparoscopically with no mortality. The mean operative time was 123.23 (±30.631) in group I and 127.57 (±42.772) in group II (p<0.05). The postoperative complications did not differ significantly between the two groups. Early complications were observed for two patients (0.9%) in the barbed suture group and for one patient (0.42%) in the multifilament suture group (p<0.05). In group I two patients (0.9%) required reoperation: on the basis of jejunojejunal stenosis in one patient, and local abscess near the gastrojejunostomy, without a leakage, in the other. In group II one patient (0.42%) required reoperation due to stenosis of the GJA. The duration of hospital admission was similar for both groups: 3.36 (±0.743) days in group I vs. 3.38 (±1.058) days in group II (p<0.05). Conclusion: The novel anastomotic technique is a safe and effective method and can be applied to gastrojejunal anastomosis and jejunojejunal anastomosis in laparoscopic gastric bypass.

Comparison of the Effects of Low Dose Methylprednisolone and Metoclopramide on Nausea and Vomiting and Respiratory Complications after Adenotonsillectomy

2021 ◽  
Vol 15 (9) ◽  
pp. 2753-2756
Author(s):  
Shahid Adalat Chaudhry ◽  
Madiha Zafar ◽  
Usman Zeeshan ◽  
Mubashar Iqbal ◽  
Arooj Fatima ◽  
...  
Keyword(s):  
Side Effects ◽  
Pain Score ◽  
Low Dose ◽  
Operative Time ◽  
Oral Intake ◽  
Respiratory Complications ◽  
Group I ◽  
Male Patients ◽  
Group Ii ◽  
Mean Time

Objective: The aim of this study is to compare the effects of low dose methylprednisolone and metoclopramide on nausea, vomiting and respiratory complications after adenotonsillectomy. Study Design: Retrospective study Place and Duration: The study was conducted in Divisional Headquarter Teaching Hospital, Mirpur AJK for duration of six months from December 2020 to May 2021. Methods: Total 150 patients of both genders underwent adenotonsillectomy presented in this study. Patients were aged between 3-15 years. Detailed demographics of enrolled cases age, sex and weight were recorded after taking informed written consent. Patients were equally divided into two groups. Group I had 75 patients and received 1 mg/kg IV methylpredinosolone and group II received 0.15 mg/kg metoclopramide among 75 patients. Post-operative effects on PONV were assessed and compared among both groups in terms of oral intake time, vomiting episodes, respiratory complications and side effects. Mean pain score was calculated by VAS. Complete data was analyzed by SPSS 23.0 version. Results: There were 40 (53.3%) females and 35 (46.7%) males in group I with mean age 9.43±1.44 years while in group II 42 (56%) were females and 33 (44%) were male patients with mean age 8.04±3.36 years. Mean weight of the patients in group I was 23.08±4.61 kg and in group II mean body weight was 22.11±6.84 kg. Mean operative time in group I was 27.41±8.53 min and in group II mean time was 28.17±6.34 min. Post-operative frequency of vomiting and nausea was lower in group I 14 (18.7%) and 16 (21.3%) as compared to group II 21 (28%) and 24 (34%). Low pain score was found in group I 1.71±6.11 as compared to group II 3.02±4.09. Time to oral intake was higher in group II 2.98±3.48 hours as compared to group I 1.09±7.51 hours. Rate of respiratory complications and side effects were significantly higher in group II. Conclusion: We concluded in this study that the use of methylpredinosolone was effective among patients those underwent for adenotonsillectomy in terms of post-operative frequency of PONV, pain, respiratory complications and side effects. Except this low dose of methylpredinosolone were effective in earlier tolerance of oral intake. Keywords: Adenotonsillectomy, Metoclopramide, Methylpredinosolone, Oral Intake

scholarly journals Roux-en-Y gastric bypass in dialysed morbidly obese patients as a preparation for a kidney transplantation: case series

2013 ◽  
Vol 2 ◽  
pp. 174-177 ◽  
Author(s):  
Monika Proczko ◽  
Łukasz Kaska ◽  
Jarek Kobiela ◽  
Tomasz Stefaniak ◽  
Dariusz Zadrożny ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Kidney Transplantation ◽  
Case Series ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Simultaneous saline irrigation during retrograde rigid ureteroscopic lasertripsy for the prevention of proximal calculus migration

2013 ◽  
Vol 7 (1-2) ◽  
pp. 65 ◽  
Author(s):  
Lu Sun ◽  
Fang-li Peng
Keyword(s):  
Operative Time ◽  
Upper Urinary Tract ◽  
Excretory Urography ◽  
Ureteral Stones ◽  
Saline Irrigation ◽  
Irrigation Method ◽  
Group I ◽  
Significant Difference ◽  
Stone Migration ◽  
Group Ii

Objective: To analyze the clinical efficacy of Simultaneous saline irrigation method in treating upper-mid ureteral stone migration and overall efficiency during ureteroscopic lasertripsy. Methods: We prospectively evaluated 78 patients with a total of 95 upper-mid ureteral stones, which were treated with holmium: YAG lasertripsy. These patients were randomized into two groups. In group I (39 cases with 44 ureteral stones), conventional ureteroscopic lasertripsy was performed in like manner. While in group II (39 cases with 51 ureteral stones), the Simultaneous saline irrigation method was used during lasertripsy. There was no significant difference between the groups with regards to stone site, size or state of the upper urinary tract by spiral computed tomography or excretory urography. Data were analyzed regarding stone migration, lengths of time, and ureteral clearing for various stages of each procedure. Results: One patients (2%) occurred upward stone migration in group II, while in group I it occurred in eight patients (20%).The operative time in group I ranged between 35 to 55 minutes (mean, 44.8±5.3), while in group II it ranged between 40 to 69 minutes (mean, 50.4±3), The operative time was no significant difference between the groups  (p<0.05). Ureteral perforation, urinoma, and urosepsis were not seen in both groups. Conclusion：Simultaneous saline irrigation method demonstrated a statistically significant advantage over the conventional methods. Operation can be performed persistently under clear vision, and the calculus can not be moved upwards, the fragmentation easily to be flushed out. Our data suggest that this method is simple，safe and effective in preventing proximal stone migration during ureteroscopic lasertripsy.

Buttressing of the EEA Stapler During Gastrojejunal Anastomosis Decreases Complications for Laparoscopic Gastric Bypass

2016 ◽  
Vol 12 (7) ◽  
pp. S15-S16
Author(s):  
Zach Ichter ◽  
Lindsey Voller ◽  
Ovet Esparza ◽  
Dan Azagury ◽  
Homero Rivas ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Laparoscopic Gastric Bypass ◽  
Gastrojejunal Anastomosis ◽  
Eea Stapler

scholarly journals Gastric proliferative lesions induced by duodenogastric reflux in rats

2006 ◽  
Vol 21 (4) ◽  
pp. 207-213 ◽  
Author(s):  
Rosângela Lucinda Rocha Monteiro ◽  
Nelson Adami Andreollo ◽  
Maria Aparecida Marchesan Rodrigues ◽  
Marina Raquel Araujo
Keyword(s):  
High Frequency ◽  
Posterior Wall ◽  
Duodenogastric Reflux ◽  
Glandular Stomach ◽  
Male Rats ◽  
Gastrojejunal Anastomosis ◽  
Adenomatous Hyperplasia ◽  
Group Iii ◽  
Group I ◽  
Group Ii

PURPOSE: To analyze mucosal proliferation and its characteristics, through specific models of duodenogastric reflux, in the stomach of Wistar rats. METHODS: Seventy-five healthy and adult male rats were divided into three groups: group I - control (n = 25 animals), submitted to gastrotomy of the posterior wall of the glandular stomach; group II - DGR (n = 25 animals), submitted to duodenogastric reflux through latero-lateral gastrojejunal anastomosis in the posterior wall of the glandular stomach and group III - DGR-P (n = 25 animals), submitted to duodenogastric reflux through the pylorus following the same procedure of group II, sectioning and closing the afferent loop. The animals were observed during 36 weeks and subsequently the mucosal lesions were analyzed, with macroscopic and microscopic examination of the prepyloric, the gastrojejunostomy and the squamous area of the stomach. RESULTS: Group I did not present any kind of lesion. Macroscopic lesions of the prepyloric area in groups II and III were 0% and 20%, respectively. Macroscopic lesions of the gastrojejunal stoma in groups II and III were 36% and 88%, respectively, and 12% and 28%, respectively, in the squamous area. Microscopically, adenomatous hyperplasia (AH), squamous hyperplasia (SH) and adenocarcinoma (AC) were diagnosed. The occurrence of AH at the prepyloric area in groups II and III was 0% and 40%, respectively, and in the gastrojejunal stoma, 40% and 72%, respectively. The occurrence of SH in the squamous area in groups II and III was 12% and 20%, respectively, without statistical differences between the groups. AC was found only in three animals of groups III (12%). CONCLUSIONS: The duodenogastric reflux in this experimental model caused high frequency of proliferative lesions of the gastrojejunal stoma and in the prepyloric area, while adenocarcinoma was a rare occurrence.

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