gastric pouch
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2022 ◽  
Author(s):  
Sullivan A. Ayuso ◽  
Jordan N. Robinson ◽  
Leslie M. Okorji ◽  
Kyle J. Thompson ◽  
Iain H. McKillop ◽  
...  

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Danilo Coco ◽  
Silvana Leanza

Background: laparoscopic adjustable gastric banding (LABG) remains the commonest and less invasive bariatric operation. It has many advantages in the treatment of obesity and is associated with low morbidity and mortality rates.When it happens a Gastric Band Slippage (GBS), part of the gastric fundus herniates through the band. Removal of GB is necessary to prevent necrosis of the herniated stomach.Case report: We present a case of a 40-year-old female patient who was admitted for a huge gastric pouch dilatation after 3 years of underwent LAGB.Conclusion: The LAGB is one of the most common procedures used for the treatment of morbid obesity. The complications are generally not mortal but it is necessary that complications have been recognized by general surgeon and physicians should be aware of the symptoms. Diagnosis of GBS can be made with signs or symptoms and patient’s medical history, with the use of oral contrast X-ray studies or CT Scan and surgical intervention is necessary.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ahmed Ibrahim Khalil ◽  
Moheb Shoraby Eskandaros ◽  
Kerolos Samy Messed Gerges

Abstract Background Obesity is a serious global epidemic and poses a significant health threat to humans. The prevalence of obesity is increasing not only in adults, but also among children and adolescents. Non-operative treatment of obesity has commonly been ineffective, and bariatric surgery has been shown to be effective in achieving substantial weight loss and improving obesity related comorbidities in the long-term. Aim of the Work Our objective in this study is to assess the effectiveness of Gastro-jejunal stomal plication (GJP) for inadequate weight loss follow Roux-en-Y gastric bypass surgery (RYGB). Patients and Methods The study will use the following search tools and databases: PubMed, Google Scholar, Cochrane Clinical Trials Database, Cochrane Review Database, EMBASE, and Allied and Complementary Medicine. Search terms included Revisional Surgery, inadequate weight loss And Roux en Y gastric bypass, then gastro-jejunal plication. These studies were published from (2009-2017). Results Eleven studies were included and these studies worked on 420 patients. Comparisons between these were done according to age, sex, time interval between (RYGB) & GJP, weight loss after GJP, laparoscopic vs open technique and overall complications of revisional surgery (GJP). Conclusion The exact reasons for weight loss failure after RYGB remain incompletely elucidated and are probably multifactorial. Pouch resizing could be a valuable option for weight loss failure or regain in selected patients with a dilated gastric pouch after RYGB in the short term. Careful selection of candidates for this procedure through psychiatric and nutritional evaluations and volumetric measures of the gastric pouch, preferably using CT, is mandatory to identify those patients most likely to benefit from revision.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yudai Hojo ◽  
Yasunori Kurahashi ◽  
Toshihiko Tomita ◽  
Tsutomu Kumamoto ◽  
Tatsuro Nakamura ◽  
...  

Abstract Background Gomez gastroplasty, which was developed in the 1970s as one of the gastric restrictive surgeries for severe obesity, partitions the stomach using a stapler from the lesser towards the greater curvature at the upper gastric body, leaving a small channel. This procedure is no longer performed due to poor outcomes, but surgeons can encounter late-onset complications even decades after the surgery. Here, we report a case of very late-onset stomal obstruction following Gomez gastroplasty which was successfully treated by revision surgery. Case presentation A 58-year-old man was referred to our institution with sudden-onset nausea and vomiting. He underwent weight loss surgery in the USA in 1979, but the details of the surgery were unclear. Esophagogastroduodenoscopy demonstrated a stoma at the greater curvature of the upper gastric body, and fluoroscopy showed retention of contrast medium in the fundus and poor outflow through the stoma. Abdominal computed tomography revealed a staple line partitioning the stomach. Considering these preoperative investigation findings and the period during which the surgery was performed, the patient was diagnosed with very late-onset stomal obstruction following Gomez gastroplasty. Supporting the preoperative diagnosis, the surgical findings revealed a staple line extending from the lesser towards the greater curvature of the upper gastric body and a channel reinforced by a running seromuscular suture on the greater curvature. Moreover, gastric torsion caused by the enlarged proximal gastric pouch was found. Re-gastroplasty involving wedge resection of the original channel was performed followed by construction of a new channel. Postoperative course was uneventful, and the patient no longer had symptoms of stomal obstruction after revision surgery. Conclusions Re-gastroplasty was safe and feasible for very late-onset stomal obstruction following Gomez gastroplasty. Accurate preoperative diagnosis based on the patient’s interview and the investigation findings was important for surgical planning. A careful follow-up is required to prevent excessive weight regain after revision surgery.


2021 ◽  
Author(s):  
Fang-Chin Hsu ◽  
Hai-Ning Hsu ◽  
Hsin-Mei Pan ◽  
Wan-Ting Hung ◽  
Guo-Shiou Liao ◽  
...  

Abstract Introduction In laparoscopic bariatric surgery, stapling devices are essential for creating a gastric tube or gastric pouch. Staple line bleeding (SLB) is an important issue, but the effect of monopolar cautery for SLB control is unclear. This study aimed to evaluate the outcomes of controlled monopolar cautery with/without oversewing for SLB control during bariatric surgery. Materials and Methods From January 2019 to May 2021, 66 patients underwent bariatric surgery with controlled monopolar cautery with/without oversewing for SLB control. Patient demographics and intraoperative and postoperative outcomes were analyzed. Results This study enrolled 35 women and 31 men (mean age: 38.1 years; mean body mass index: 39.8 kg/m2). All patients had varying degrees of SLB. Controlled monopolar cautery was applied to 63 patients with ≤6 bleeding sites. Only two patients needed further partial oversewing of the bleeding sites after controlled monopolar cautery failed to achieve hemostasis. Initially, three patients had more than six bleeding sites, and thus complete oversewing was performed to achieve successful hemostasis. There was no intraabdominal or gastrointestinal bleeding. There were one gastric stricture, one anastomotic leakage, and one staple line leakage. Conclusions The strategy of controlled monopolar cautery with/without oversewing is a simple, practical, inexpensive, and safe method for SLB control during bariatric surgery.


2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Safiye E. Sarper ◽  
Tamami Hirai ◽  
Take Matsuyama ◽  
Shigeru Kuratani ◽  
Koichi Fujimoto

AbstractSymmetry in the arrangement of body parts is a distinctive phylogenetic feature of animals. Cnidarians show both bilateral and radial symmetries in their internal organs, such as gastric pouches and muscles. However, how different symmetries appear during the developmental process remains unknown. Here, we report intraspecific variations in the symmetric arrangement of gastric pouches, muscles, and siphonoglyphs, the Anthozoan-specific organ that drives water into the organism, in D. lineata (Diadumenidae, Actiniaria). We found that the positional arrangement of the internal organs was apparently constrained to either biradial or bilateral symmetries depending on the number of siphonoglyphs. Based on the morphological observations, a mathematical model of internal organ positioning was employed to predict the developmental backgrounds responsible for the biradial and bilateral symmetries. In the model, we assumed that the specification of gastric pouches is orchestrated by lateral inhibition and activation, which results in different symmetries depending on the number of siphonoglyphs. Thus, we propose that a common developmental program can generate either bilateral or biradial symmetries depending on the number of siphonoglyphs formed in the early developmental stages.


2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
Ana Navío-Seller ◽  
Raquel Jiménez-Rosellón ◽  
Marcos Bruna-Esteban ◽  
Javier Vaqué-Urbaneja ◽  
Fernando Mingol-Navarro

Abstract   Superior polar gastrectomy remains an accepted surgical alternative for proximal gastric tumors, although this approach has higher rates of gastroesophageal reflux since the valvular mechanism of cardias disappears. Thus, an additional technique is needed to avoid its presence. Methods This is a description of surgical technique and short term results of superior polar gastrectomy associated to Kamikawa’s anti-reflux technique in a female patient with proximal gastric cancer. Results A 55 year-old female diagnosed with gastric adenocarcinoma. Tumor was 3 cm long, from esophago-gastric junction to subcardial region (cT3N1M0). Patient underwent perioperative chemotherapy and surgical intervention 6 weeks later. A laparoscopic superior polar gastrectomy was performed and D1+ lymphadenectomy. A laparotomy was made to externalize the surgical specimen. Saline solution was injected into submucosa of gastric pouch and two seromuscular flaps were dissected. Gastric mucous membrane was opened in the inferior part of the flaps, constructing an esophagogastric end-to-side anastomosis. Seromuscular flaps were sewn overlapping the esophago-gastric anastomosis. Patient presented an optimal postoperative evolution, without heartburn, dysphagia neither vomiting. Conclusion The procedure described here is feasible and performable, and achieves correct oncological results avoiding performing a total gastrectomy and improving the gastroesophageal reflux problems derived from a superior polar gastrectomy.


Author(s):  
Valerio Ceriani ◽  
Ferdinando Pinna ◽  
Antonio Galantino ◽  
Ahmed S. Zakaria ◽  
Roberto Manfrini ◽  
...  

Abstract Aims Bariatric surgeries induce profound weight loss (decrease in body mass index, BMI), through a decrease in fat mass (FM) and to a much lesser degree of fat-free mass (FFM). Some reports indicate that the weight which is lost after gastric bypass (RYGB) and sleeve gastrectomy (SG) is at least partially regained 2 years after surgery. Here we compare changes in BMI and body composition induced by four bariatric procedures in a 5 years follow-up study. Methods We analyzed retrospectively modifications in BMI, FM and FFM obtained through Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), biliopancreatic diversion (BPD) and a long common limb revisional biliopancreatic diversion (reduction of the gastric pouch and long common limb; BPD + LCL−R). Patients were evaluated at baseline and yearly for 5 years. Of the whole cohort of 565 patients, a subset of 180 patients had all yearly evaluations, while the remaining had incomplete evaluations. Setting University Hospital. Results In a total of 180 patients evaluated yearly for 5 years, decrease in BMI and FM up to 2 years was more rapid with RYGB and SG than BPD and BPD + LCL−R; with RYGB and SG both BMI and FM slightly increased in the years 3–5. At 5 years, the differences were not significant. When analysing the differences between 2 and 5 years, BPD + LCL−R showed a somewhat greater effect on BMI and FM than RYGB, BPD and SG. Superimposable results were obtained when the whole cohort of 565 patients with incomplete evaluation was considered. Conclusions All surgeries were highly effective in reducing BMI and fat mass at around 2 years; with RYGB and SG both BMI and FM slightly increased in the years 3–5, while BPD and BPD + LCL−R showed a slight further decreases in the same time interval.


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