Comprehensive Care for Bariatric Surgery Patients

2017 ◽  
Vol 28 (3) ◽  
pp. 263-274
Author(s):  
Aura Petcu
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Treatment Options ◽  
Surgical Care ◽  
The United States ◽  
Bariatric Patients ◽  
Technical Simplicity ◽  
Perioperative Course

Obesity is a worldwide epidemic, and those suffering from obesity have increased morbidity and mortality rates. There are various causes of obesity and many treatment options for patients suffering from obesity, including nonsurgical treatments. However, bariatric surgery is often the best choice for optimal weight loss and the attenuation of comorbidities. Currently, laparoscopic sleeve gastrectomy is the most common type of bariatric surgery in the United States due to its technical simplicity, feasibility, and overall positive outcomes. This article discusses bariatric surgical criteria and selection, expected perioperative course, potential complications after surgery, and nursing implications for the care of bariatric patients. A case report is used to exemplify stages of surgical care and follow-up treatment for patients who undergo laparoscopic sleeve gastrectomy.

scholarly journals Laparoscopic Sleeve Gastrectomy for the Surgical Treatment of Obesity: Is It an Easy Procedure?

2021 ◽  
Vol 6 (1) ◽  
pp. e1-e1
Author(s):  
Emilio Manno ◽  
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Simple Procedure ◽  
Longitudinal Gastrectomy ◽  
Technical Simplicity ◽  
Treatment Of Obesity ◽  
Malabsorptive Procedure ◽  
Global Registry ◽  
Registry Report

Laparoscopic sleeve gastrectomy (LSG) is currently the most performed bariatric procedure in the world. The 4th International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Global registry report (2014-18) estimates 87,015 procedures, equal to 45.9% of all bariatric procedures. Initially performed as the first step of the duodenals witch (biliopancreatic diversion with duodenal switch (BPD-DS)), a very complex malabsorptive procedure invented by a Canadian Surgeon P. Marceau as an evolution of the BPD, invented by N. Scopinaro, an Italian surgeon, LSG established itself in the early 2000s as a stand alone procedure, especially following the observations of Michael Gagner, pioneer of bariatric surgery. Over the years LSG has grown rapidly. The reasons for this popularity are the relative technical simplicity compared to other procedures, efficacy, good quality. For these reasons there has been a real explosion of bariatric surgery: many surgeons, driven by the relative simplicity of the procedure (longitudinal gastrectomy on the guide of a probe), begun to propose this procedure. So is LSG really an effective simple procedure that is good for all patients? Absolutely not. Performing a longitudinal gastrectomy can be simple; performing a good LSG is not.

scholarly journals GERD after Bariatric Surgery. Can We Expect Endoscopic Findings?

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 506
Author(s):  
Ramon Vilallonga ◽  
Sergi Sanchez-Cordero ◽  
Nicolas Umpiérrez Mayor ◽  
Alicia Molina ◽  
Arturo Cirera de Tudela ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Review Of The Literature ◽  
Endoscopic Findings ◽  
Asymptomatic Patients ◽  
Bariatric Patients ◽  
Specific Care

Background and Objectives: Bariatric surgery remains the gold standard treatment for morbidly obese patients. Roux-en-y gastric bypass and laparoscopic sleeve gastrectomy are the most frequently performed surgeries worldwide. Obesity has also been related to gastroesophageal reflux disease (GERD). The management of a preoperative diagnosis of GERD, with/without hiatal hernia before bariatric surgery, is mandatory. Endoscopy can show abnormal findings that might influence the final type of surgery. The aim of this article is to discuss and review the evidence related to the endoscopic findings after bariatric surgery. Materials and Methods: A systematic review of the literature has been conducted, including all recent articles related to endoscopic findings after bariatric surgery. Our review of the literature has included 140 articles, of which, after final review, only eight were included. The polled articles included discussion of the endoscopy findings after roux-en-y gastric bypass and laparoscopic sleeve gastrectomy. Results: We found that the specific care of bariatric patients might include an endoscopic diagnosis when GERD symptoms are present. Conclusions: Recent evidence has shown that endoscopic follow-up after laparoscopic sleeve gastrectomy could be advisable, due to the pathological findings in endoscopic procedures in asymptomatic patients.

Weight Loss Ten Years After Bariatric Surgery: A Review of the Literature

2020 ◽  
Vol 13 (1) ◽  
pp. 19-27
Author(s):  
Toni I. Stoyanov ◽  
Pedro Cascales-Sanchez ◽  
Kaloyan T. Ivanov ◽  
Agustina Martinez-Moreno ◽  
Servando Usero-Rebollo ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Vertical Band Gastroplasty ◽  
Surgical Techniques ◽  
Morbidly Obese ◽  
Operation Rate

Summary Introduction: Bariatric surgery has amply demonstrated its benefit in the treatment of morbidly obese patients. After surgery, there is a progressive and significant decrease in weight in a high percentage of patients. Most comorbidities resolve, improving quality of life and increasing life expectancy. Methods and Objective: The literature review is based on a 10-year or longer follow-up of patients who underwent various bariatric surgery procedures. The long-term weight loss results and the clinical impact were evaluated. Results: The applied surgical techniques, including Rouxen-Y gastric Bypass (RYBG), Biliopancreatic Diversion, Scopinaro type (BPD), and Duodenal Switch (DS), have contributed to achieving very satisfactory long-term and sustainable weight loss results. According to the reviewed literature, the percentage of excessive BMI Loss (%EBMIL) for the various techniques was 67.9%, 70.7%, and 71.5% for RYGB, BPD, and DS, respectively. Patients undergoing BGYR have lost much more weight than non-surgical patients and can maintain long-term weight loss, reaching a Percentage of Excessive Weight Loss (%EWL) as high as 56.4% in 10 years. Patients who underwent Adjustable Gastric Band (AGB) presented with a %EWL of 45.9% in 10 years, but with very high re-operation rate range (8-78%). There are few studies in the literature on Laparoscopic Sleeve Gastrectomy, reporting weight loss results over ten years. According to the study carried out by Arman G. A., Himpens J., et al. isolated Laparoscopic Sleeve Gastrectomy (LGS) produced a satisfactory weight loss over ten years, reachingEBMIL of 62.5%. Amending LSG with a new surgical design with malabsorbtive component (in 25% of patients) increased the weight loss, achieving %EBMIL of 81.7%.The Vertical Band Gastroplasty technique resulted in EWL of 38.1 ± 28.8%, as shown by a mean follow-up of 17.3 years, with a high rate of re-operations and conversions.

An alternative method of surgical treatment of refractory GERD following laparoscopic sleeve gastrectomy

2019 ◽  
Vol 98 (5) ◽  
pp. 214-218
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Postoperative Period ◽  
Close Association ◽  
Treatment Options ◽  
Alternative Method ◽  
Refractory Gerd ◽  
Prevalence Of Obesity ◽  
The Relationship

Obesity has become a global problem with increasing prevalence. Undoubtedly, bariatric surgery is the most effective way to treat morbid obesity. Laparoscopic sleeve gastrectomy (LSG) is currently the most commonly performed bariatric procedure worldwide. The prevalence of gastroesopha- geal reflux disease (GERD) is also increasing, a close association with increasing prevalence of obesity being regarded as the main cause of this trend. The relationship between LSG and GERD is still unclear, at least controversial. If GERD occurs in the postoperative period, the first therapeutic intervention is initiation of proton pump inhibitors (PPI) treatment, which is effective in the vast majority of patients. In patients resistant to this treatment, conversion to laparoscopic Roux en Y gastric bypass (LRYGB) is usually necessary. The authors present the case report of a patient who developed GERD in the longer postoperative period and conversion to LRYGB was not appropriate due to previous complications and surgical procedures. Therefore, this patient was managed operatively by an alternative method – hiatoplasty with partial posterior fundoplication. The success of the treatment was confirmed clinically by disappearance of GERD symptomatology postoperatively even after PPI discontinuation. LRYGB is the method of choice for GERD after restrictive bariatric procedures. However, some patients are not suitable for conversion to LRYGB, and alternative treatment options are therefore needed.

scholarly journals Trends in Bariatric Surgery Procedures among Patients with ESKD in the United States

2019 ◽  
Vol 14 (8) ◽  
pp. 1193-1199 ◽  
Author(s):  
Kyle H. Sheetz ◽  
Kenneth J. Woodside ◽  
Vahakn B. Shahinian ◽  
Justin B. Dimick ◽  
John R. Montgomery ◽  
...  
Keyword(s):  
United States ◽  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Confidence Interval ◽  
Practice Patterns ◽  
Surgical Care ◽  
The United States ◽  
Complication Rates ◽  
Linear Regression Models ◽  
Number Of Patients

Background and objectivesDespite the potential for improving health status or increasing access to transplantation, national practice patterns for bariatric surgery in obese patients with ESKD are poorly understood. The purpose of this study was to describe current trends in surgical care for this population.Design, setting, participants, & measurementsUsing 100% Medicare data, we identified all beneficiaries undergoing bariatric surgery in the United States between 2006 and 2016. We evaluated longitudinal practice patterns using linear regression models. We also estimated risk-adjusted complications, readmissions, and length of stay using Poisson regression for patients with and without ESKD.ResultsThe number of patients with ESKD undergoing bariatric surgery increased ninefold between 2006 and 2016. The proportional use of sleeve gastrectomy increased from <1% in 2006 to 84% in 2016. For sleeve gastrectomy, complication rates were similar between patients with and without ESKD (3.4% versus 3.6%, respectively; difference, −0.3%; 95% confidence interval, −1.3% to 0.1%; P=0.57). However, patients with ESKD had more readmissions (8.6% versus 5.4%, respectively; difference, 3.2%; 95% confidence interval, 1.9% to 4.6%; P<0.001) and slightly longer hospitals stays (2.2 versus 1.9 days, respectively; difference, 0.3; 95% confidence interval, 0.1 to 0.4; P<0.001).ConclusionsThis study suggests that laparoscopic sleeve gastrectomy has replaced Roux-en-Y gastric bypass as the most common bariatric surgical procedure in patients with ESKD. The data also demonstrate a favorable complication profile in patients with sleeve gastrectomy.

scholarly journals Laparoscopic sleeve gastrectomy in a patient withsitus inversus totalisand Kartagener syndrome: an unusual surgical conundrum

2019 ◽  
Vol 12 (7) ◽  
pp. e229550
Author(s):  
Angela Burvill ◽  
Ruth Blackham ◽  
Jeffrey Hamdorf
Keyword(s):  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Situs Inversus ◽  
Autosomal Recessive ◽  
Situs Inversus Totalis ◽  
Team Approach ◽  
Kartagener Syndrome ◽  
Autosomal Recessive Condition

Kartagener syndrome is a rare autosomal recessive condition. Approximately 25% of those withsitus inversus totalissuffer the syndrome. With the rising overall number and indications for bariatric surgery, this condition will be increasingly recognised. We present a case of a 25-year-old woman withSITand Kartagener syndrome who underwent a laparoscopic sleeve gastrectomy. As with all bariatric surgery, a multidisciplinary team approach was important in managing such a case. There were considerable cognitive challenges for the surgical team both preoperatively and during the procedure. The patient tolerated the operation well and was discharged 2 days after the surgery. At 12-months follow-up, the patient had achieved 125% excess weight loss. This case illustrates that an experienced surgeon can safely perform a laparoscopic sleeve gastrectomy on a patient withsitus inversus totalis.

scholarly journals Efficacy of laparoscopic sleeve gastrectomy for patient with morbid obesity and type 1 diabetes mellitus: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Hidetaka Ichikawa ◽  
Hirofumi Imoto ◽  
Naoki Tanaka ◽  
Hiroaki Musha ◽  
Shojiro Sawada ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Body Weight ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Hba1c Level ◽  
Insulin Dose ◽  
Body Weight Loss

Abstract Background Bariatric surgery is effective for the treatment of patients with morbid obesity and type 2 diabetes mellitus (T2DM), for body weight loss and glycemic control. However, in Japan, there has been no previous report of the effectiveness bariatric surgery in a case of morbid obesity associated with acute onset type 1 diabetes mellitus (T1DM), in which pancreatic β-cells were destroyed and endogenous insulin was depleted. Case presentation A 36-year-old woman with morbid obesity and T1DM, diagnosed when she was 6 years, was admitted for bariatric surgery. At her first consultation, she had a body weight of 106.7 kg and a body mass index of 42.2 kg/m2. Her HbA1c level was 9.0%, with a required daily insulin dose of 75 units. She underwent laparoscopic sleeve gastrectomy. At 1 year after surgery, her body weight had decreased to 81.0 kg and her body mass index to 32.2 kg/m2. In addition, her daily required dose of insulin had decreased to 24 units, with an improvement in her HbA1c level to 7.7%. Conclusions Although further evidence needs to be accumulated, including long-term outcomes, laparoscopic sleeve gastrectomy may provide an effective treatment for patients with morbid obesity and T1DM for body weight loss, improvement in HbA1c level, and insulin dose reduction.

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