scholarly journals A prospective observational study investigating postoperative hemorrhage after laparoscopic sleeve gastrectomy using Bipolar Seal and Cut Caiman® (Aesculap AG)

2021 ◽  
Author(s):  
Clara Boeker ◽  
Frank Brose ◽  
Martina Mall ◽  
Julian Mall ◽  
Christian Reetz ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Hospital Stay ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Postoperative Hemorrhage ◽  
Bleeding Complications ◽  
Average Hospital ◽  
Vessel Sealing

Introduction  Postoperative hemorrhage (POH) is the second most important acute complication following laparoscopic sleeve gastrectomy (LSG), with staple line leakage being the first. POH is reported in up to 5% of cases after LSG. Sufficient vessel sealing is crucial in avoiding later complications of POH during mobilization. This study investigated bleeding complications after LSG using the Advanced Bipolar Seal and Cut instrument Caiman 5 by Aesculap AG.  Methods  All LSG´s were performed using the Caiman 5 (Aesculap AG). Primary outcome was the incidence of POH, defined as the need for revisional surgery and/or blood transfusions. Secondary outcomes were hemoglobin levels preoperatively at the day of surgery (POD 0) and at postoperative days (POD) 1 and 2, volume and duration of drainage at POD 0-2, procedure time, and length of hospital stay.  Results  100 patients who had undergone LSG from April 2016 to September 2017 were consecutively included in the study. Patients with contraindications to undergo LSG or were not able to give consent were excluded. Four patients needed treatment due to POH, in 3 of them surgery became necessary. Average operation time was 68.5 min, total volume of drainage was 186 ml. The drain stayed in situ for 2.2 days (mean). Average hospital stay was 3.6 days.  Discussion/Conclusion  In our study group of 100 LSG procedures POH was 4%. Operation time, volume and duration of drainage, length of hospital stay were not prolonged. LSG using Caiman is feasible and shows comparable results to other vessel sealing instruments at our center.

scholarly journals Clinical characteristics and postoperative complications of patients who underwent laparoscopic sleeve gastrectomy due to obesity A Single Center Experience

2020 ◽  
Vol 7 (12) ◽  
pp. 745-749
Author(s):  
Mehmet Patmano ◽  
Durmuş Ali Çetin ◽  
Tufan Gümüş ◽  
Hasan Elkan
Keyword(s):  
Sleeve Gastrectomy ◽  
Postoperative Complications ◽  
Hospital Stay ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Developed Countries ◽  
Late Complications ◽  
Average Hospital ◽  
Mortality And Morbidity ◽  
Preoperative Body Mass Index ◽  
The Mean

Objective:   Obesity, which is considered as a chronic disease today, has become an epidemic problem especially in developed countries. Laparoscopic sleeve gastrectomy (LSG) is currently one of the most common bariatric procedures in obesity treatment. This study aimse aims to present our demographic, clinical, histopathological and postoperative early and late complications of patients who underwent LSG. Material and Methods: Patients who underwent LSG due to obesity between March 2018 and December 2019 in our clinic were included in the study. The patients' age, gender, comorbid diseases, preoperative body mass index (BMI) and length of hospital stay, postoperative complications and pathology results were recorded retrospectively. Results: Of the 278 patients included in the study, 201 (72.3%) were female, 77 (27.6%) were male and the mean age was 36.2 (min: 18-max: 60 years). The mean BMI of the patients was 46.4 (min: 35.2-max: 75.1). The average hospital stay of the patients was 4.2 days (3-13 days). When the early and late complications of the patients are examined; It was observed that 25 (8.9%) patients developed early postoperative complications, and 2 (0.7%) patients developed late postoperative complications. Conclusion: LSG is a reliable surgical method with low mortality and morbidity rates. It is important that we do not have mortality and that our morbidity is within acceptable limits. Bariatric surgery is an effective and reliable application in the treatment of obesity and metabolic surgery today, in terms of its results, if the right patient is selected and performed in experienced centers.

scholarly journals Prophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy could reduce the frequency of portomesenteric venous thrombosis

2020 ◽  
Vol 102 (9) ◽  
pp. 712-716
Author(s):  
JI Rodríguez ◽  
V Kobus ◽  
I Téllez ◽  
G Pérez
Keyword(s):  
Sleeve Gastrectomy ◽  
Venous Thrombosis ◽  
Hospital Stay ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Bleeding Complications ◽  
Mesenteric Venous Thrombosis ◽  
Post Discharge ◽  
Bleeding Episodes ◽  
Group 2 ◽  
Group 1

Introduction Portal and mesenteric venous thrombosis is a rare but potentially serious complication after laparoscopic sleeve gastrectomy. There are no consistent studies that prove the safety and effectiveness of oral anticoagulant thromboprophylaxis with rivaroxaban after laparoscopic sleeve gastrectomy. The objective was to evaluate the effect of rivaroxaban on the frequency of portal and mesenteric venous thrombosis and its safety profile after laparoscopic sleeve gastrectomy. Materials and methods This retrospective analysis of prospectively collected data includes all laparoscopic sleeve gastrectomies performed by a single surgeon at Pontificia Universidad Católica de Chile Hospital between January 2009 and June 2019. All patients received low molecular weight heparin thromboprophylaxis during the whole hospital stay. Between July 2012 and June 2019, patients received additional post-discharge thromboprophylaxis with rivaroxaban. Patient demographics, impaired renal, post-surgical portal and mesenteric venous thrombosis, and bleeding episodes were registered. Results A total of 516 patients were identified; 95 patients were excluded. Results for 421 patients were analysed: 198 received only intrahospital thromboprophylaxis (group 1) and 223 received additional post-discharge thromboprophylaxis with rivaroxaban (group 2). There was no statistically significant difference between the two groups concerning age, sex and body mass index. In group 1, four cases of portal and mesenteric venous thrombosis were registered and no cases were reported in group 2 (p < 0.05). All cases occurred before 30 days after surgery. No bleeding episodes and no adverse reactions were detected in group 2. Conclusions Thromboprophylaxis during the whole hospital stay (two to three days), followed by rivaroxaban 10mg once daily for 10 days after discharge (completing in total 13–14 days of prophylaxis), could reduce cases of post-surgical portal and mesenteric venous thrombosis without an increase in bleeding complications.

scholarly journals Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

2022 ◽  
Vol 11 (2) ◽  
pp. 436
Author(s):  
Paulina Głuszyńska ◽  
Inna Diemieszczyk ◽  
Łukasz Szczerbiński ◽  
Adam Krętowski ◽  
Piotr Major ◽  
...  
Keyword(s):  
Risk Factors ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Late Complications ◽  
P Value ◽  
Early Complications ◽  
Tertiary Institution ◽  
Planning Optimization

Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

scholarly journals Risk Factors for Prolonged Length of Hospital Stay and Readmissions After Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-en-Y Gastric Bypass

2017 ◽  
Vol 28 (2) ◽  
pp. 323-332 ◽  
Author(s):  
Piotr Major ◽  
Michał Wysocki ◽  
Grzegorz Torbicz ◽  
Natalia Gajewska ◽  
Alicja Dudek ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Hospital Stay ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Length Of Hospital Stay ◽  
Prolonged Length

scholarly journals The transpalpebral approach “eyelid incision” for surgical management of intracranial tumors: A 10-years’ experience

2020 ◽  
Vol 11 ◽  
pp. 186
Author(s):  
Mohamed Elnokaly ◽  
Gordon Mao ◽  
Khaled A. Aziz
Keyword(s):  
Hospital Stay ◽  
Skull Base ◽  
Tumor Resection ◽  
Length Of Hospital Stay ◽  
Anterior Skull Base ◽  
Cosmetic Outcome ◽  
Intracranial Tumors ◽  
Average Hospital ◽  
Anatomical Dissection ◽  
Skull Base Lesions

Background: The minimally invasive approaches to the anterior skull base region through fronto-orbital craniotomy remain a highly accepted option that gains countenance and predilection over time. The transpalpebral “eyelid” incision is an under-utilized and more recent technique that offers a safe efficient corridor to manage a wide variety of lesions. Methods: We carried a retrospective study of 44 patients operated on by the fronto-orbital craniotomy through transpalpebral “eyelid” incision for intracranial tumors, in the time period from March 2007 to July 2016. The results from surgeries were analyzed; extent of tumor resection, length of hospital stay, cosmetic outcome, and complications. Results: Out of the 44 intracranial tumor cases, we had 16 male and 28 female patients with median age 54 years. We had 19 anterior skull base lesions, 8 middle skull base lesions and 8 parasellar lesions. We also operated on four frontal intraparenchymal lesions and four other various lesions. Total resection was achieved in 32 cases (72.7%), with excellent cosmetic outcome in 43 cases (97.7%). Average hospital stay was 6 days. No major complications recorded. Three cases (6.8%) had complications that varied between pseudomeningocele, wound infections, and facial pain. Follow-up average period was 23.6 months. Conclusion: The fronto-orbital approach through eyelid incision remains a reliable approach to the skull base. It provides natural anatomical dissection planes through the eyelid incision and a fronto-orbital craniotomy, creating a wide surgical corridor to manage specific lesions with consistent surgical and cosmetic outcome.

Laparoscopic Surgical Management of Rectal Cancer at Tertiary Care Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3285-3287
Author(s):  
Zubair Yousfani ◽  
Jabeen Atta ◽  
Khenpal Das ◽  
Madhu Bala ◽  
Shagufta Magsi ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Laparoscopic Surgery ◽  
Hospital Stay ◽  
Tertiary Care ◽  
Case Series ◽  
Operation Time ◽  
Health Sciences ◽  
Care Hospital ◽  
Average Hospital ◽  
Case Series Study

Objective: To evaluate the consequent outcomes in the patients with rectal cancer endured laparoscopic surgical excision at Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro, Hyderabad and to review their curative resection and recurrence rates, postoperative morbidities and complete survival. Methods: This prospective case series study was done at the Department of General Surgery of Liaquat University of Medical & Health Sciences, Jamshoro, Sindh, Pakistan. All patients of 30-65 years ages with rectal cancer and underwent diagnostic laparoscopy either of gender were included. After removing the tumor, the specimen pinned out on a flat surface and placed in fixative solution to allow the orientation of the specimen and assessments of the exact margins. As the specimens had acceptable clear margins and limited invasion to the submucosa, no further surgical procedure was proceeded. Data was collected via study proforma. Results: A total of 40 patients were studied. Patients in the laparoscopic operation lost less blood with an amount of only 200mL during 190 minutes average operation time. The bowel functioning returned in 2 days averagely with 8 days average hospital stay. Conclusion: It is concluded that laparoscopic surgery for rectal cancer is an effective, safe and feasible approach in terms of less post-operative complications and recovery time as well as Hospital stay. Key words: Rectal Cancer, laparoscopic surgery

scholarly journals Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass after Failed Gastric Banding

2020 ◽  
Author(s):  
Michał Janik ◽  
Christopher Ibikunle ◽  
Ahad Khan ◽  
Amir H. Aryaie
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Gastric Banding ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Revisional Surgery ◽  
Perioperative Complications ◽  
Single Step ◽  
Single Stage ◽  
Step Procedure ◽  
User File

Abstract Background Reoperation, after failed gastric banding, is a controversial topic. A common approach is band removal with conversion to laparoscopic Roux-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) in a single-step procedure. Objective This study aimed to assess the safety of revisional surgery to LSG compared to LRYGB after failed laparoscopic adjustable gastric banding (LAGB) based on MBSAQIP Participant User File from 2015 to 2018. Methods Patients who underwent a one-stage conversion of LAGB to LSG (Conv-LSG) or LRYGB (Conv-LRYGB) were identified in the MBSAQIP PUF from 2015 to 2017. Conv-LRYGB cases were matched (1:1) with Conv-LSG patients using propensity scoring to control for potential confounding. The primary outcome was all-cause mortality. Results A total of 9974 patients (4987 matched pairs) were included in the study. Conv-LRYGB, as compared with conv-SG, was associated with a similar risk of mortality (0.02% vs. 0.06%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.03 to 3.20, p = 0.32). Conversion to LRYGB increased the risk for readmission (6.16% vs. 3.77%; RR, 1.63; 95%CI, 1.37 to 1.94, p < 0.01); reoperation (2.15% vs. 1.36%; RR, 1.57; 95%CI, 1.17 to 2.12, p = <0.01); leak (1.76% vs. 1.02%; RR, 1.57; 95%CI, 1.72 to 2.42, p < 0.01); and bleeding (1.66% vs. 1.00%; RR, 1.66; 95%CI, 1.7 to 2.34, p < 0.01). Conclusions The study shows that single-stage LRYGB and LSG as revisional surgery after gastric banding, are safe in the 30-day observation with an acceptable complication rate and low mortality. However, conversion to LRYGB increased the risk of perioperative complications.

scholarly journals Nighttime Appendectomy is Safe and has Similar Outcomes as Daytime Appendectomy: A Study of 1198 Appendectomies

2020 ◽  
pp. 145749692093860
Author(s):  
T. Mönttinen ◽  
H. Kangaspunta ◽  
J. Laukkarinen ◽  
M. Ukkonen
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Time Of Day ◽  
University Hospital ◽  
Patient Comfort ◽  
Intraoperative Bleeding ◽  
Significant Difference ◽  
Clinically Significant

Introduction: Although it is controversial whether appendectomy can be safely delayed, it is often unnecessary to postpone operation as a shorter delay may increase patient comfort, enables quicker recovery, and decreases costs. In this study, we sought to study whether the time of day influences the outcomes among patients operated on for acute appendicitis. Materials and Methods: Consecutive patients undergoing appendectomy at Tampere University Hospital between 1 September 2014 and 30 April 2017 for acute appendicitis were included. Primary outcome measures were postoperative morbidity, mortality, length of hospital stay, and amount of intraoperative bleeding. Appendectomies were divided into daytime and nighttime operations. Results: A total of 1198 patients underwent appendectomy, of which 65% were operated during daytime and 35% during nighttime. Patient and disease-related characteristics were similar in both groups. The overall morbidity and mortality rates were 4.8% and 0.2%, respectively. No time categories were associated with risk of complications or complication severity. Neither was there difference in operation time and clinically significant difference in intraoperative bleeding. Patients undergoing surgery during night hours had a shorter hospital stay. In multivariate analysis, only complicated appendicitis was associated with worse outcomes. Discussion: We have shown that nighttime appendectomy is associated with similar outcomes than daytime appendectomy. Subsequently, appendectomy should be planned for the next available slot, minimizing delay whenever possible.

scholarly journals Laparoscopic Gastric Plication versus Laparoscopic Sleeve Gastrectomy: An Up-to-Date Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Konstantinos Perivoliotis ◽  
Eleni Sioka ◽  
Georgia Katsogridaki ◽  
Dimitrios Zacharoulis
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Reoperation Rate ◽  
Quality Level ◽  
Gastric Plication ◽  
Laparoscopic Gastric Plication ◽  
Larger Sample

Introduction. A meta-analysis was conducted in order to provide an up-to-date comparison of laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric plication (LGP) for morbid obesity.Materials and Methods. The PRISMA guidelines andthe Cochrane Handbook for Systematic Reviews of Interventionswere used for the conduction of this study. A systematic literature search was performed in the electronic databases (MEDLINE, CENTRAL, and Web of Science and Scopus). The fixed effects or random effects model was used according to the Cochran Q test.Results. Totally, 12 eligible studies were extracted. LSG displayed a statistically significant lower rate of overall complications (OR: 0.35; 95% CI: 0.17, 0.68;p=0.002) and a sustainable higher %EWL through all time endpoints (OR: 4.86,p=0.04; OR: 7.57,p<0.00001; and OR: 13.74;p<0.00001). There was no difference between the two techniques in terms of length of hospital stay (p=0.16), operative duration (p=0.81), reoperation rate (p=0.51), and cost (p=0.06).Conclusions. LSG was demonstrated to have a lower overall complications and a higher weight loss rate, when compared to LGP. Further RCTs of a higher methodological quality level, with a larger sample size, are required in order to validate these findings.

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