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

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.

  • laparoscopic single site surgery for placement of an adjustable Gastric Band initial experience
    Surgical Endoscopy and Other Interventional Techniques, 2009
    Co-Authors: Julio Teixeira, Kevin M Mcgill, Steven Binenbaum, G Forrester
    Abstract:

    Background Laparoendoscopic single-site (LESS) surgery for cholecystectomy and appendectomy are described in the literature. The benefits of these procedures compared with traditional laparoscopic approaches have yet to be determined. To date, no series of LESS surgeries for placement of an adjustable Gastric Band has been published or documented. This study aimed to determine the safety and feasibility of LESS surgery for placement of an adjustable Gastric Band.

Paul E Obrien - One of the best experts on this subject based on the ideXlab platform.

  • diabetes outcomes more than a decade following sustained weight loss after laparoscopic adjustable Gastric Band surgery
    Obesity Surgery, 2018
    Co-Authors: Wendy A. Brown, Stewart Skinner, John M Wentworth, Cheryl Laurie, Paul R. Burton, Chloe Cheng, Paul E Obrien
    Abstract:

    Background Long-term outcome data are needed to define the role of bariatric surgery in type 2 diabetes (T2D). To address this, we collated diabetes outcomes more than a decade after laparoscopic adjustable Gastric Band (LAGB) surgery.

  • criteria for assessing esophageal motility in laparoscopic adjustable Gastric Band patients the importance of the lower esophageal contractile segment
    Obesity Surgery, 2010
    Co-Authors: Paul R. Burton, Wendy A. Brown, Cheryl Laurie, Geoff Hebbard, Paul E Obrien
    Abstract:

    Background Esophageal function appears critical in laparoscopic adjustable Gastric Band (LAGB) patients; however, conventional motility assessments have not proven to be clinically useful. Recent combined video fluoroscopic and high-resolution manometric studies have identified important components of esophageal function in LAGB patients.

  • shoulder pain is a common problem following laparoscopic adjustable Gastric Band surgery
    Obesity Surgery, 2005
    Co-Authors: John Dixon, Yigal Reuben, Christine R Halket, Paul E Obrien
    Abstract:

    Background: Shoulder-tip pain is commonly reported following laparoscopic adjustable Gastric Band (LAGB) placement. The incidence, nature and factors that may increase the risk of pain have not been explored. Methods: A prospective extensive collection of patient characteristics and operative details was obtained from consecutive patients having Band placement for severe obesity. Postoperatively, the presence and characteristics of shoulder pain were obtained using a structured interview at discharge from hospital, and at 1 and 5 weeks after placement. Results: 66% and 21% of patients at 1 and 5 weeks respectively following surgery reported pain predominantly in the left shoulder. At 5 weeks, only 7% found the pain of concern and 5% required analgesics. There were no factors found that predicted the presence and severity of pain at 1 week. Injury to the crus of the diaphragm (OR 4.2, 1.4-12.6, P=0.01) and a past history of any upper abdominal surgery (OR 4.2, 1.5-11.7, P=0.007) independently predicted an increased risk of pain at 5 weeks. Conclusion: Shoulder pain following LAGB surgery is common, usually affects the left shoulder, and can in some cases last 5 weeks or more. Avoiding injury to the crura during the procedure may prevent more prolonged pain.

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

Lilian Kow - One of the best experts on this subject based on the ideXlab platform.