INCIDENTALLY DISCOVERED INTESTINAL NON-ROTATION AT TIME OF BARIATRIC SURGERY: WHICH OPERATION TO PERFORM?
Gary Ko, MD, Boris Zevin, MD, PhD. Queen's UniversityIntestinal non-rotation is a rare congenital anomaly that may be discovered at time of bariatric surgery. This incidental finding poses two dilemmas to the surgeon 1) which bariatric procedure should be performed and 2) should an appendectomy be performed concurrently. In this video case report, we discuss… Continue Reading
LAPAROSCOPIC EXPLORATION FOR INTERNAL HERNIAS IS BEST PRACTICE DURING ANY RETURN TO OR AFTER LAPAROSCOPIC GASTRIC BYPASS
Ransford Commey, MD, Ryan Lehmann, DO, FACS, FASMBS, Norbert Richardson, MD, FACS, FASMBS. St Alexius HospitalBackground: Following laparoscopic gastric bypass, internal hernia can occur at Petersen’s space and at the jejunojejunostomy mesenteric defect, which can lead to potentially serious complications, and as such, must be promptly diagnosed and treated. Port site hernia is a long… Continue Reading
ALTERNATIVE METHOD OF MESENTERIC DEFECT CLOSURE AFTER ROUX-EN-Y GASTRIC BYPASS
Eugene Wang, MD, Timothy Shope, MD. Medstar Washington Hospital CenterThis video demonstrates our method of closing the mesenteric defects after a Roux-en-Y gastric bypass. In common schematics representing mesenteric defects after Roux en Y gastric bypasses, the alimentary limb is on the patient’s right side, and the biliopancreatic limb is on the left side, with… Continue Reading
MINIMAL INCISIONS ONE ANASTOMOSIS GASTRIC BYPASS. Video Presentation.
Tomas C Jakob, MD, Patricio Cal, Luciano Deluca, Fernandez Ezequiel. Hospital ChurrucaIntroduction: Least possible trauma, discomfort and loss of productivity are a common goal for surgeons and health care systems. Due to an exponential growth of Bariatric and Metabolic procedures, medical training and technological development are continuously improving, leading to defy the boundaries of minimally… Continue Reading
Why is it so hard to preserve the pylorus? A step-by-step illustration of the D-loop.
Walter Medlin, MD, FACS, Daniel Cottam, MD, Amit Surve, MD, Hinali Zaveri, MD, Christina Richards, MD, FACS, LeGrand Belnap, MD, Austin Cottam, HS, Samuel Cottam, HS. Bariatric Medicine InstituteLaparoscopic D-loop (duodenal loop) can be performed as an isolated operation or as a part of the stomach intestinal pylorus-sparing surgery (SIPS) or single anastomosis duodeno-ileostomy with… Continue Reading
Laparoscopic Roux-en-Y Gastric Bypass for obesity developing after previous Heller myotomy and anterior fundoplication for achalasia
Stephanie Manning, Dr1, Mark Smith, Mr2. 1Department of General Surgery, Hutt Hospital, New Zealand, 2Department of General Surgery, Dunedin Hospital, New ZealandIntroduction: The incidence of morbid obesity in the USA is increasing (38% of people over the age of 20 in 2014)(1), along with the rates of bariatric surgery. Achalasia itself is a rare entity,… Continue Reading
Intraoperative Complications of Laparoscopic Sleeve Gastrectomy
Michael C Morell, MD1, Brandon T Grover, DO2. 1Gundersen Medical Foundation, 2Gundersen Health SystemLaparoscopic sleeve gastrectomy is a common operation performed by bariatric surgeons for the treatment of obesity and its related diseases. This case study outlines the basic concepts of the gastric sleeve operation, highlights specific complications that may be encountered during surgery and… Continue Reading
ROBOTIC SINGLE ANASTOMOSIS GASTRIC BYPASS WITH TOTAL GASTRECTOMY OF THE REMNANT
Patricio Cal, MD, Luciano Deluca, MD, Tomas Jakob, MD, Diego Lonardi, MD, Ezequiel Fernandez, MD. Hospital Churruca38-year-old woman, BMI 45.2, with insulin dependent type 2 diabetes. Multiple hyperplastic polyps were diagnosed in the preop endoscopy. Decision was taken to perform a robotic single anastomosis gastric bypass with total gastrectomy of the remnant. After setup of… Continue Reading
Hematoma after Sleeve Gastrectomy Causing Gastric Outlet Obstruction and Severe Malnourishment.
Rami R Mustafa, MD, Leena Khaitan, MDMPH, Ananda Ghimire, PA, Benjamin Jons, PA, Tomasz Rogula, MDPhD. Cleveland Medical CenterIntroduction: Sleeve Gastrectomy is one of the most common bariatric procedures. Risks include stapler line bleeding. Chronic anticoagulation for VTE prophylaxis may increase risk of bleeding. Meticulous surgical hemostasis is needed to prevent from such complications. Stapler… Continue Reading
Robotic Duodenal Switch: Neutralizing Complexity
Courtney N Cripps, MD, James L Taggart, MD, Caitlin P Olson, MD, Julio A Teixeira, MD, FACS. Northwell Health-Lenox Hill HospitalWe present the case of a 43-year-old female patient with a BMI of 71 who underwent a robotic duodenal switch after failing repeated attempts at weight loss through lifestyle modification. The particular relevance of this… Continue Reading
Laparoscopic Roux-en-Y gastric bypass: A VDO of variety technique of Gastrojejunal anastomosis.
Jakrapan Wittayapairoch1, Iithiphon Viratanapanu2, Worawit Kattipatanapong2, Kongpong Tangpanitandee2, Suppa-ut Pungpapong2, Krit Kritsin2, Chadin Tharavej2, Patpong Navicharern2, Suthep Udomsawaengsup2. 1Khon Kaen University, 2Chulalongkorn UniversityGastrojejunal(GJ) anastomosis is the most important step of laparoscopic Roux-en-Y gastric bapass(LRYGB). Circular staple technique is routinely procedure in Bariatric and metabolic institute of Chulalongkorn Memorial hospital, however others technique can be used… Continue Reading
Laparoscopic repair of anterior diaphragmatic hernia after Roux-en-Y gastric bypass
Jessica Ardila-Gatas, MD, Linden Karas, MD, Ali Aminian, MD. Cleveland ClinicIntroduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most common bariatric procedure performed to date. Complications can develop early or late in the postoperative course. When patients present with symptoms of GI obstruction, the surgeon should have a high suspicion for internal hernia… Continue Reading
Surgical Management of Postprandial Hyperinsulinemic Hypoglycemia after Roux-en-Y Gastric Bypass
Jessica Ardila-Gatas, MD, Linden Karas, MD, Julia Simkowski, BS, M. Cecilia Lansang, MD, PhD, Ali Aminian. Cleveland ClinicIntroduction: Postprandial hyperinsulinemic hypoglycemia (PPH) usually occurs one year after Roux-en-Y gastric bypass surgery (RYGB), presenting with normal fasting glucose and insulin levels, inappropriately high postprandial insulin and C-peptide levels, and a low glucose level. Anatomical changes after… Continue Reading
Conversion of Sleeve to Bypass: Two Different Methods
Jeffrey E Quigley, DO, Manuel Garcia, MD, Esther Wu, MD, Stephanie Keeth, DNP, Aarthy Kannappan, MD, Daniel Srikureja, MD, Marcos Michelotti, MD, FACS, Keith R Scharf, DO, FACS, FASMBS. Loma Linda University HealthSleeve gastrectomy (SG) is currently the most commonly performed restrictive bariatric procedure. The number of SG cases has increased sharply and overtaken Roux-en-Y… Continue Reading
The long-term system and surgeon cost efficiencies of gastric bypass
Aristithes Doumouras, MD, MPH1, Fady Saleh, MD, MPH2, Scott Gmora, MD1, Mehran Anvari, MD, PhD1, Dennis Hong, MD, MSc1. 1McMaster University, 2William Osler HealthcareBackground: Gastric bypass is an important public health procedure with economic benefit to society. Understanding system factors, including the individual surgeon cost efficiencies, is vital to ensuring optimal economic benefit. Therefore, this… Continue Reading
- Metabolic / Obesity