scholarly journals PROSPECTIVE META-ANALYSIS OF RELEASED WEIGHT LOSS AND SUCCESS RATE OF ARGON PLASMA COAGULATION TO SUTURE AND SURGERY PROCEDURES POST-BARIATRIC SURGERY: STATUS OF THE ART OF ENDOSCOPIC TREATMENT

2021 ◽  
Author(s):  
Dr. Idiberto Jose Zotarelli Filho, MSc, Ph.D
Keyword(s):  
Weight Loss ◽  
Argon Plasma Coagulation ◽  
Meta Analysis ◽  
Argon Plasma ◽  
High Association ◽  
Plasma Coagulation ◽  
Vertical Gastrectomy ◽  
Significant Difference ◽  
Α Level ◽  
Post Bariatric Surgery

Introduction: Currently, 30% of the world’s population is overweight or obese. Roux-en-Y gastric bypass (BGYR) and vertical gastrectomy are the most commonly performed techniques in Brazil and worldwide. Objective: Conduct a meta-analysis of the results of using argon plasma coagulation (APC), suture (SUT), and surgery (SUR), to clarify the safety and efficacy of using argon plasma to other procedures. Methods: The quality of the evidence was classified as high, moderate, low, or very low, according to the risk of bias. The Variance (α2) and One-Way (ANOVA) test were applied, adopting the α level less than 0.05 with a statistically significant difference for the 95% CI. The value of R-sq (R2) was analyzed to discover the imprecision or heterogeneity of the analyzes. Results: A total of 34 studies were found, eight to APC, twenty to SUT, and six to SUR. For relapsed weight loss (RWL), the means for APC, SUT, and SUR were respectively 19.39 ± 10.94, 26.06 ± 16.71, and 17.05 ± 9.85, and for SR, the means were respectively 89.75 ± 16.75, 86.80 ± 11.44, and 76.00 ± 21.57. There was a small difference between the values of APC averages with SUT and SUR, both in relation to RWL and SR, with p>0.05, with a high association (R2 ≥ 50%). Conclusion: It was shown that the APC technique showed excellent results in terms of RWL and SR compared to the other techniques, with no statistically significant difference. Thus, the results of the APC strongly point to its potential use.

scholarly journals OUTLET ROUX-Y-GASTRIC BYPASS POUCH REDUCTION USING ARGON PLASMA COAGULATION TO TREAT WEIGHT REGAIN: A Randomized Controlled Trial with SHAM Group

2021 ◽  
Author(s):  
Dr. Idiberto Jose Zotarelli Filho, MSc, Ph.D
Keyword(s):  
Weight Loss ◽  
Weight Regain ◽  
Sham Group ◽  
Controlled Trial ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Control Group ◽  
Initial Weight ◽  
Plasma Coagulation ◽  
The Mean

Aims: This study to evaluate the efficacy and complications of Argon Plasma Coagulation (APC) therapy to treat post-RYGB weight regain compared to a sham control group. Methods: 41 Patients with minimum regain of 10 kg and minimal postoperative time of 36 months was randomized into two groups. Results: In the APC group (n=21), the mean initial weight 100.4 kg, and mean regained weight of 24.94 kg. In the Sham group (n=20), the mean initial weight of 103.65 kg, and mean regained weight of 25.18 kg. Only happened anastomosis stenosis after the first APC session. The comparative results between the APC versus the Sham were percentage recovered weight loss (63.95 x-2.65), weight loss in kg (15.02 x-0.57), percentage total weight loss (14.46 x-0.62), % excess weight loss (54.32 x-2.34), and BMI reduction (5.38 x-0.21), with a p<0.0001 for all the comparisons. There was a significant reduction in the APC group of HbA1c (5.66% to 4.96%) and triglycerides (153.20mg/dL to 132.20mg/dL). Conclusion: This study proves that APC outlet pouch reduction is much superior compared to sham in promoting weight loss for patients that presented weight regain after de RYGB.

Argon plasma coagulation tonsillectomy versus coblation tonsillectomy: a comparison of efficacy and safety

2019 ◽  
Vol 133 (06) ◽  
pp. 520-525 ◽  
Author(s):  
R Loh ◽  
L Stepan ◽  
E Zhen ◽  
C-K L Shaw
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Standard Technique ◽  
Cost Effective ◽  
Operative Blood Loss ◽  
Plasma Coagulation ◽  
Post Operative Pain ◽  
Significant Difference

AbstractBackgroundTonsillectomy is one of the most common otolaryngological procedures. Nonetheless, there is still no universally approved ‘gold standard’ technique.ObjectiveTo compare the safety and efficacy of argon plasma coagulation and coblation techniques in tonsillectomy.MethodsA multi-institutional, retrospective cohort study was conducted, comprising 283 patients who underwent bilateral tonsillectomies performed by a single surgeon between 2014 and 2017. The outcome measures included: operative time, intra-operative blood loss, post-operative pain and post-operative haemorrhage.ResultsIn the argon plasma coagulation group, mean operative time and post-operative haemorrhage rate were significantly reduced, p = 0.0006 and p = 0.003 respectively. There was no statistically significant difference between the two groups in terms of post-operative pain and intra-operative blood loss.ConclusionThe argon plasma coagulation technique is easy, safe and efficacious. Argon plasma coagulation tonsillectomy seems cost-effective compared to coblation tonsillectomy: the single-use disposable electrode tip and wand used in this study cost AUD$76.50 and AUD$380 respectively. Argon plasma coagulation appears to be a favourable alternative to current modalities such as coblation.

scholarly journals A145 A SUBMUCOSAL FLUID CUSHION PREVENTS MUSCLE LAYER DAMAGE DURING ARGON PLASMA COAGULATION

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 8-9
Author(s):  
P J Belletrutti ◽  
R Maselli ◽  
T Stabler ◽  
M D Enderle ◽  
A Repici
Keyword(s):  
Normal Saline ◽  
Thermal Damage ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Muscle Layer ◽  
Tissue Temperature ◽  
Final Temperature ◽  
Injection Volume ◽  
Plasma Coagulation ◽  
Significant Difference

Abstract Background Thermal damage to the muscle layer of the gastrointestinal wall can occur during mucosal application of argon plasma coagulation (APC). This injury may be mitigated by creating a fluid cushion within the submucosal layer that physically separates the mucosa from the muscle layer and suppresses unwanted tissue temperature elevation. This in turn protects the muscle layer from thermal damage. The coagulative threshold of muscle proteins is known to be about 60°C, but there are no published systematic assessments of the minimum injection volume needed nor the ideal injectate to prevent thermal damage to the muscle layer during mucosal APC ablation. Aims Our aims were, firstly, to measure the final temperature inside the fluid cushion after mucosal ablation with APC and then to determine any differences in the final temperature between various injectable solutions. Secondly, we sought to determine the minimum volume of injectate required to protect the muscle layer from thermal damage. Methods All experiments were performed in an ex-vivo porcine gastrointestinal tract model. Five different fluids (normal saline, Glyceol, Gelafundin, Voluven and Eleview) of different volumes (range 0 - 5mL) were injected into the submucosa of the esophagus, stomach (fundus) and rectum to create a fluid cushion. APC was applied to the mucosa for a fixed duration (3s) at different power settings (ranging from 30 - 120W). Immediately after APC treatment, the final temperature was measured by placing a contact thermometer inside the fluid cushion, just on top of the muscle layer. Results There was no significant difference in the temperature measured at the surface of the muscle layer between elevation with normal saline, Glyceol, Gelafundin, Voluven and Eleview at all 3 tissue locations at equal injection volumes and power settings. The experiments showed that the temperature rose for each injectate with heightened power settings but also decreased with increasing volume of injected fluid. The minimum amount of fluid needed to protect the muscle layer from thermal damage was 2mL for the esophagus, stomach and rectum in the case of a power setting between 30 to 90W and 3mL in the case of 90 to 120W. Conclusions Normal saline and four commercially available submucosal injectates possess similar thermoregulatory effects as an insulator of the muscle layer during APC treatment. As opposed to the choice of injectate or anatomic location treated, the volume of fluid injected is the main determinant of the final temperature at the level of the muscularis propria. To reduce the likelihood of thermal damage to deeper layers of the GI tract when APC is applied, a minimum injection volume of 2mL is recommended if &lt;90W of power is utilized. Funding Agencies None

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