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Adjustable Gastric Band

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Julio Teixeira – One of the best experts on this subject based on the ideXlab platform.

  • laparoendoscopic single site surgery for the placement of an Adjustable Gastric Band a large cohort comparison
    Surgery for Obesity and Related Diseases, 2013
    Co-Authors: Koji Park, John N Afthinos, S S Razi, Elaine Chan, Julio Teixeira
    Abstract:

    Abstract Background Laparoendoscopic single-site (LESS) surgery has been shown to be a well-tolerated alternative for the placement of an Adjustable Gastric Band. To date, only small series have suggested that this approach may provide potential clinical benefits over standard multiport laparoscopy. The objective of this study was to compare the outcomes of patients undergoing LESS Adjustable Gastric Banding (LESS-AGB) and a cohort of patients undergoing standard multiport laparoscopic Adjustable Gastric Banding (LAGB). Methods A total of 206 patients underwent placement of an Adjustable Gastric Band. Of these, 106 patients underwent LESS-AGB and were compared with a demographically similar cohort of 100 patients who underwent standard LAGB. Data collected included operative time, parenteral and oral narcotic consumption, duration of patient controlled analgesia (PCA) device, subjective pain scores using the 0–10 numeric pain intensity scale, and length of stay. Unpaired t test was used for analysis. Results Compared with multiport LAGB patients, LESS-AGB patients reported significantly less pain at the first postoperative hour ( P = .012), twelfth postoperative hour ( P = .017), and twenty-fourth postoperative hour ( P = .012), and consumed fewer oral analgesic tablets ( P = .012). Operative times were significantly longer in the LESS-AGB group ( P = .029). No significant differences were seen in duration of PCA, parenteral narcotic consumption, or length of stay. One LESS-AGB case required conversion to multiport laparoscopy. Complication rates were similar between the 2 groups. Conclusion LESS-AGB is associated with less pain and less oral analgesic consumption than multiport LAGB. Given these clinical advantages and superior cosmetic results, laparoendoscopic single-site surgery may be an attractive alternative approach for patients considering LAGB. (Surg Obes Relat Dis 2013;0;000–00.) © 2013 American Society for Metabolic and Bariatric Surgery. All rights reserved.

  • laparoscopic single site surgery for placement of Adjustable Gastric Band
    Surgical technology international, 2010
    Co-Authors: Julio Teixeira
    Abstract:

    : We present a series of patients who have undergone laparo-endoscopic single-site (LESS) surgery for placement of an Adjustable Gastric Band. From December 2007 to December 2008, LESS surgery to place an Adjustable Gastric Band was performed via a trans-umbilical incision. Essentially, multiple ports were placed through a single incision in the umbilicus to allow for liver retraction, visualization, and working instruments. All critical steps using a standard pars flaccida technique were not altered. Twenty-two patients were carefully selected, including 20 women and 2 men ranging in age from 18 to 67 with a mean age of 42. All patients were discharged home within the 23-hour admission window, and there were no perioperative complications noted. In addition, there were no wound-related complications. LESS surgery for Adjustable Gastric Band shows this technique to be both feasible and safe in selected patients to date. Although technical limitations exist that will undoubtedly be improved upon, further studies must be performed to compare LESS surgery for placement of an Adjustable Gastric Band to traditional laparoscopic techniques.

  • laparoscopic single site surgery for placement of Adjustable Gastric Band a series of 22 cases
    Surgery for Obesity and Related Diseases, 2010
    Co-Authors: Julio Teixeira, Kevin M Mcgill, Nina Koshy, James Mcginty, George J Todd
    Abstract:

    BACKGROUND: We present a series of 22 patients who underwent laparoendoscopic single-site (LESS) surgery for placement of an Adjustable Gastric Band at a U.S. university hospital. METHODS: From December 2007 to December 2008, LESS surgery, through a transumbilical incision, to place an Adjustable Gastric Band was performed on 22 patients under institutional review board approval. Multiple ports were placed through a single incision in the umbilicus to allow for liver retraction, visualization, and the working instruments. None of the critical steps of the standard pars flaccida technique were altered. RESULTS: A total of 22 patients were carefully selected and included 20 women and 2 men, with an age range of 18-67 years (mean 42). The mean body mass index was 42 kg/m(2) (range 35-45). The exclusion criteria included hepatomegaly, central obesity, previous abdominal surgery, and super-obesity. The mean operative time was 84 minutes (range 53-111). All patients were discharged home within the 23-hour admission, and no perioperative complications were noted. In addition, no wound-related complications developed. One patient required conversion to conventional laparoscopy. No intraoperative or postoperative complications occurred. CONCLUSION: In our experience, LESS surgery for Adjustable Gastric Band placement shows this technique to be both feasible and safe in selected patients to date. Although technical limitations exist that will be improved on, additional studies are needed to compare LESS surgery for placement of an Adjustable Gastric Band with traditional laparoscopic techniques.

Malcolm K Robinson – One of the best experts on this subject based on the ideXlab platform.

Wendy A. Brown – One of the best experts on this subject based on the ideXlab platform.

Elizabeth S Ginsburg – One of the best experts on this subject based on the ideXlab platform.

  • Reproductive Outcomes Differ Following Roux-en-Y Gastric Bypass and Adjustable Gastric Band Compared with Those of an Obese Non-Surgical Group
    Obesity Surgery, 2016
    Co-Authors: Randi H Goldman, Stacey A Missmer, Malcolm K Robinson, Leslie V Farland, Elizabeth S Ginsburg
    Abstract:

    Background Little is known about how bariatric surgery type may impact reproductive health outcomes. Our objective was to determine differences in infertility and birth outcomes among women who underwent Roux-en-Y Gastric bypass (RYGB), Adjustable Gastric Band (AGB), and an obese non-surgical group. Methods Women aged 18–45 who were evaluated for bariatric surgery were invited to complete a survey. Pre- and post-surgery outcomes were compared among women who underwent RYGB vs. AGB and to those of obese women who decided against surgery. Outcomes included infertility, time to conception from first attempt, use of infertility services, pregnancy, live birth, and birth weights. Logistic and linear regression, controlling for age, BMI, weight, and pregnancy history, were used to calculate odds ratios (ORs) and beta-coefficients with 95 % confidence intervals (CIs). Results Two-hundred nineteen surveys were completed. RYGB resulted in a reduction in menstrual cycle irregularity after surgery compared to before (OR = 0.21, CI = 0.07–0.61). For first-pregnancy outcomes, there were lower odds of term birth after RYGB than before (OR = 0.21, CI = 0.05–0.90) and increased odds of miscarriage after RYGB compared to the no-surgery group (OR = 9.81, CI = 1.12–85.71). We found lower odds of live birth after AGB than before (OR = 0.19, CI = 0.05–0.73). Birth weight was significantly lower after RYGB but not AGB ( p  

  • reproductive outcomes differ following roux en y Gastric bypass and Adjustable Gastric Band compared with those of an obese non surgical group
    Obesity Surgery, 2016
    Co-Authors: Randi H Goldman, Stacey A Missmer, Malcolm K Robinson, Leslie V Farland, Elizabeth S Ginsburg
    Abstract:

    Background Little is known about how bariatric surgery type may impact reproductive health outcomes. Our objective was to determine differences in infertility and birth outcomes among women who underwent Roux-en-Y Gastric bypass (RYGB), Adjustable Gastric Band (AGB), and an obese non-surgical group.

James Toouli – One of the best experts on this subject based on the ideXlab platform.

  • international multicenter study of safety and effectiveness of swedish Adjustable Gastric Band in 1 3 and 5 year follow up cohorts
    Surgery for Obesity and Related Diseases, 2009
    Co-Authors: James Toouli, Piet Pattyn, Lillian Kow, Almino Ramos, F Aigner, Manoel P Galvaoneto, Karl Miller, Stefania Romano, Mario Gutierrez, Jeremy D Jokinen
    Abstract:

    Abstract Background No long-term, international, multicenter studies of the effectiveness and safety of the SAGB in morbid obesity have been previously published. The objective of this study was to assess the effectiveness and safety of the Swedish Adjustable Gastric Band (SAGB) at 6 bariatric centers in Australia, Europe, and Brazil, with ≤5 years of follow-up; the effect on patient covariates; and changes in co-morbidity. Methods A 2-phase study design was used, involving both retrospective and prospective data. SAGB was implanted by way of the pars flaccida 1, 3, and 5 years previously. The retrospective phase entailed a review of the records. The prospective phase included a subset of eligible patients who agreed to undergo additional clinical assessments. The percentage of excess weight loss (%EWL), patient level predictors, change in co-morbidities, and complications were analyzed. Results A total of 481 patients in 3 mutually exclusive follow-up cohorts (1 yr, n=200; 3 yr, n=184; 5 yr, n=97) participated in the present study. Of these 481 patients, 339 (1 yr, n=139; 3 yr, n=131; 5 yr, n=69) underwent prospective evaluations. The mean %EWL was 43.5% ± 21.8%, 57.7% ± 25.9%, and 49.8% ± 27.6% and the mean change in body mass index was −7.64, −10.75, and −9.52 in the 1-, 3-, and 5-year cohorts, respectively ( P Conclusion SAGB is safe and effective in inducing weight loss and improvement of co-morbidities in morbidly obese patients at international bariatric centers at 1, 3, and 5 years postoperatively.

  • Efficacy of a low-pressure laparoscopic Adjustable Gastric Band for morbid obesity: patients at long term in a multidisciplinary center.
    Surgery for Obesity and Related Diseases, 2008
    Co-Authors: James Toouli, Jane Collins, Ann C. Schloithe, Chris Oppermann
    Abstract:

    BACKGROUND: Obesity is an increasingly common condition with serious associated morbidity and decreased life expectancy. Laparoscopic Adjustable Gastric Banding (LAGB) has demonstrated its safety and efficacy as a surgical therapy for morbid obesity over the short term. The current study sought to determine the long-term safety and efficacy of a low-pressure LAGB. METHODS: Between August 1996 and July 2007, 1,000 consecutive patients underwent LAGB implantation with the Swedish Adjustable Gastric Band (SAGB). This series was retrospectively reviewed with regard to weight loss and morbidity. Patients served as their own controls. RESULTS: Preoperatively, there were 808 women (81.0%) and 192 men (19.0%) with a mean age of 46 +/- 11 years (range 13-81 yrs) and mean body mass index (BMI) of 42.0 +/- 7.0 kg/m2 (range 27-82 kg/m2). At 1-, 3-, 6-, and 8-year follow-up, mean percent excess weight loss was 41% (n = 600), 56% (n = 367), 51% (n = 114), and 52% (n = 43), respectively. At the same time points, BMI decreased, from 42.0 to 31.0, 32.5, and 30.5 kg/m2, respectively. Complications occurred in 197 patients. There were 2 operative complications (i.e., stomach perfperforation and vascular injury) and 25 conversions (2.4%) to open surgery. Major and minor wound infection in the perioperative period occurred in 47 (4.7%) and 43 (4.3%) patients, respectively. There was 1 death from a myocardial infarct 1 week after surgery. Long term, there were 30 (3.0%) Band slippages, 31 (3.1%) erosions, 67 (6.7%) port problems, and 12 (1.2%) incisional hernias. CONCLUSION: LAGB with the SAGB is effective in achieving a mean sustainable weight loss of >50% at 8 years after surgery, with an acceptably low morbidity.

  • long term efficacy of a low pressure Adjustable Gastric Band in the treatment of morbid obesity
    Annals of Surgery, 2008
    Co-Authors: Mohamed N Anwar, Lilian Kow, Jane Collins, James Toouli
    Abstract:

    Objective:To determine the long-term efficacy and safety of a low-pressure Adjustable Gastric Band in the treatment for morbid obesity and to detect whether age, gender, or preoperative body mass index (BMI) has an impact on the outcome.Background:It is well known that low-pressure Adjustable gastri