The Experts below are selected from a list of 150 Experts worldwide ranked by ideXlab platform
Raul J Rosenthal - One of the best experts on this subject based on the ideXlab platform.
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t tube gastrostomy as a novel approach for distal staple line disruption after Sleeve gastrectomy for morbid obesity case report and review of the literature
Obesity Surgery, 2010Co-Authors: Ismael Court, Samuel Szomstein, Aaron Wilson, Peter N Benotti, Raul J RosenthalAbstract:Laparoscopic Sleeve gastrectomy has recently become a feasible option in the management of morbid obesity. One of the most feared complications of this procedure is staple line disruption and leakage. There are, to our knowledge, few literature reports that try to explain the reasons and management of this rare but serious complication. We report a case of staple line disruption that was managed using a T-tube gastrostomy. A 50-year-old female, 2 weeks status post-Sleeve gastrectomy in an outside facility, was admitted to the emergency room at Cleveland Clinic Florida with new onset of fever, abdominal pain, jaundice, hematemesis, and melena. A computed tomography scan of the abdomen revealed a large extravasation of contrast material parallel to the Gastric Sleeve. A diagnostic laparoscopy was performed that showed a distal and proximal disruption of the staple line. A T-tube gastrostomy with a large proximal and distal limb was placed into the most distal area of disruption. After thorough over sewing and drainage of the proximal site and T-tube, a feeding jejunostomy was placed. The T-tube permitted to control the leak and to have a controlled fistula. Four weeks postoperatively, the T-tube was removed after the patient had a negative Gastrografin study and tolerated oral fluids with a clamped T-tube. The long-term recovery and follow-up were uneventful. T-tube gastrostomy appears to be a safe and feasible treatment option for staple line disruption after vertical Sleeve gastrectomy. Early detection and drainage remain the most important principles to manage this type of complication.
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indications for Sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese
Journal of Gastrointestinal Surgery, 2008Co-Authors: Olga Tucker, Samuel Szomstein, Raul J RosenthalAbstract:Single-stage laparoscopic Sleeve gastrectomy (LSG) may represent an additional surgical option for morbid obesity. We performed a retrospective review of a prospectively maintained database of LSG performed from November 2004 to April 2007 as a one-stage primary restrictive procedure. One hundred forty-eight LSGs were performed as primary procedures for weight loss. The mean patient age was 42 years (range, 13–79), mean body mass index of 43.4 kg/m2 (range, 35–75), mean operative time of 60 min (range, 58–190), and mean blood loss of 60 ml (range, 0–300). One hundred forty-seven procedures (99.3%) were completed laparoscopically, with a mean hospital stay of 2.7 days (range, 2–25). A 2.7% major complication rate was observed with four events in three patients and no deaths. Four patients required readmission; mild dehydration in two, choledocholithiasis in one, and a Gastric Sleeve stricture in one. Laparoscopic SG is a safe one-stage restrictive technique as a primary procedure for weight loss in the morbidly obese with an acceptable operative time, intraoperative blood loss, and perioperative complication rate.
Frits J. Berends - One of the best experts on this subject based on the ideXlab platform.
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the Gastric Sleeve losing weight as fast as micronutrients
Obesity Surgery, 2011Co-Authors: Edo O. Aarts, I. M. C. Janssen, Frits J. BerendsAbstract:Background Recently, the laparoscopic Sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched.
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The Gastric Sleeve: Losing weight as fast as micronutrients?
Obesity Surgery, 2011Co-Authors: Edo O. Aarts, I. M. C. Janssen, Frits J. BerendsAbstract:BACKGROUND: Recently, the laparoscopic Sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched.\n\nMETHODS: From January 2005 to October 2008, 60 patients underwent LSG. All patients were instructed to take daily vitamin supplements. Patients were tested for micronutrient deficiencies 6 and 12 months after surgery.\n\nRESULTS: Anemia was diagnosed in 14 (26%) patients. Iron, folic acid, and vitamin B12 deficiency was found in 23 (43%), eight (15%), and five (9%) patients, respectively. Vitamin D and albumin deficiency was diagnosed in 21 (39%) and eight (15%) patients. Hypervitaminosis A, B1, and B6 were diagnosed in 26 (48%), 17 (31%), and 13 (30%) patients, respectively.\n\nCONCLUSIONS: Due to inadequate intake and uptake of micronutrients, patients who underwent LSG are at serious risk for developing micronutrient deficiencies. Moreover, some vitamins seem to increase to chronic elevated levels with possible complications in the long-term. Multivitamins and calcium tablets should be regarded only as a minimum and supplements especially for iron, vitamin B12, vitamin D, and calcium should be added to this regimen based on regular blood testing.
Gerhard Prager - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic Sleeve gastrectomy as an isolated bariatric procedure intermediate term results from a large series in three austrian centers
Obesity Surgery, 2008Co-Authors: F X Felberbauer, Felix B Langer, Soheila Shakerimanesch, Elisabeth Schmaldienst, Mathias Kees, Stephan Kriwanek, Manfred Prager, Gerhard PragerAbstract:Background Gastric Sleeve resection was initially planned as the first step of bilio-pancreatic diversion with duodenal switch but it continues to emerge as a restrictive bariatric procedure on its own. We describe intermediate results in a series of 126 laparoscopic Sleeve gastrectomies (LSG) compiled from three bariatric centers in eastern Austria.
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does Gastric dilatation limit the success of Sleeve gastrectomy as a sole operation for morbid obesity
Obesity Surgery, 2006Co-Authors: Felix B Langer, Arthur Bohdjalian, Franz X Felberbauer, Edith Fleischmann, M A Hoda, Bernhard Ludvik, Johannes Zacherl, R Jakesz, Gerhard PragerAbstract:Background: Sleeve gastrectomy as the sole bariatric operation has been reported for high-risk super-obese patients or as first-step followed by Roux-en-Y Gastric bypass (RYGBP) or duodenal switch (DS) in super-super obese patients. The efficacy of laparoscopic Sleeve gastrectomy (LSG) for morbidly obese patients with a BMI of 12 months. Results: Patients who underwent LSG achieved a mean excess weight loss (EWL) at 6 and 12 months postoperatively of 46% and 56%, respectively. No significant differences were observed in %EWL comparing obese and super-obese patients. At a mean follow-up of 20 months, dilatation of the Gastric Sleeve was found in 1 patient and weight regain after initial successful weight loss in 3 of the 23 patients. Conclusion: LSG has been highly effective for weight reduction for morbid obesity even as the sole bariatric operation. Gastric dilatation was found in only 1 patient in this short-term follow-up. Weight regain following LSG may require conversion to RYGBP or DS. Follow-up will be necessary to evaluate long-term results.
Edo O. Aarts - One of the best experts on this subject based on the ideXlab platform.
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the Gastric Sleeve losing weight as fast as micronutrients
Obesity Surgery, 2011Co-Authors: Edo O. Aarts, I. M. C. Janssen, Frits J. BerendsAbstract:Background Recently, the laparoscopic Sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched.
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The Gastric Sleeve: Losing weight as fast as micronutrients?
Obesity Surgery, 2011Co-Authors: Edo O. Aarts, I. M. C. Janssen, Frits J. BerendsAbstract:BACKGROUND: Recently, the laparoscopic Sleeve gastrectomy (LSG) has become popular as a single-stage procedure for the treatment of morbid obesity and its co-morbidities. However, the incidence of micronutrient deficiencies after LSG have hardly been researched.\n\nMETHODS: From January 2005 to October 2008, 60 patients underwent LSG. All patients were instructed to take daily vitamin supplements. Patients were tested for micronutrient deficiencies 6 and 12 months after surgery.\n\nRESULTS: Anemia was diagnosed in 14 (26%) patients. Iron, folic acid, and vitamin B12 deficiency was found in 23 (43%), eight (15%), and five (9%) patients, respectively. Vitamin D and albumin deficiency was diagnosed in 21 (39%) and eight (15%) patients. Hypervitaminosis A, B1, and B6 were diagnosed in 26 (48%), 17 (31%), and 13 (30%) patients, respectively.\n\nCONCLUSIONS: Due to inadequate intake and uptake of micronutrients, patients who underwent LSG are at serious risk for developing micronutrient deficiencies. Moreover, some vitamins seem to increase to chronic elevated levels with possible complications in the long-term. Multivitamins and calcium tablets should be regarded only as a minimum and supplements especially for iron, vitamin B12, vitamin D, and calcium should be added to this regimen based on regular blood testing.
Samuel Szomstein - One of the best experts on this subject based on the ideXlab platform.
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t tube gastrostomy as a novel approach for distal staple line disruption after Sleeve gastrectomy for morbid obesity case report and review of the literature
Obesity Surgery, 2010Co-Authors: Ismael Court, Samuel Szomstein, Aaron Wilson, Peter N Benotti, Raul J RosenthalAbstract:Laparoscopic Sleeve gastrectomy has recently become a feasible option in the management of morbid obesity. One of the most feared complications of this procedure is staple line disruption and leakage. There are, to our knowledge, few literature reports that try to explain the reasons and management of this rare but serious complication. We report a case of staple line disruption that was managed using a T-tube gastrostomy. A 50-year-old female, 2 weeks status post-Sleeve gastrectomy in an outside facility, was admitted to the emergency room at Cleveland Clinic Florida with new onset of fever, abdominal pain, jaundice, hematemesis, and melena. A computed tomography scan of the abdomen revealed a large extravasation of contrast material parallel to the Gastric Sleeve. A diagnostic laparoscopy was performed that showed a distal and proximal disruption of the staple line. A T-tube gastrostomy with a large proximal and distal limb was placed into the most distal area of disruption. After thorough over sewing and drainage of the proximal site and T-tube, a feeding jejunostomy was placed. The T-tube permitted to control the leak and to have a controlled fistula. Four weeks postoperatively, the T-tube was removed after the patient had a negative Gastrografin study and tolerated oral fluids with a clamped T-tube. The long-term recovery and follow-up were uneventful. T-tube gastrostomy appears to be a safe and feasible treatment option for staple line disruption after vertical Sleeve gastrectomy. Early detection and drainage remain the most important principles to manage this type of complication.
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indications for Sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese
Journal of Gastrointestinal Surgery, 2008Co-Authors: Olga Tucker, Samuel Szomstein, Raul J RosenthalAbstract:Single-stage laparoscopic Sleeve gastrectomy (LSG) may represent an additional surgical option for morbid obesity. We performed a retrospective review of a prospectively maintained database of LSG performed from November 2004 to April 2007 as a one-stage primary restrictive procedure. One hundred forty-eight LSGs were performed as primary procedures for weight loss. The mean patient age was 42 years (range, 13–79), mean body mass index of 43.4 kg/m2 (range, 35–75), mean operative time of 60 min (range, 58–190), and mean blood loss of 60 ml (range, 0–300). One hundred forty-seven procedures (99.3%) were completed laparoscopically, with a mean hospital stay of 2.7 days (range, 2–25). A 2.7% major complication rate was observed with four events in three patients and no deaths. Four patients required readmission; mild dehydration in two, choledocholithiasis in one, and a Gastric Sleeve stricture in one. Laparoscopic SG is a safe one-stage restrictive technique as a primary procedure for weight loss in the morbidly obese with an acceptable operative time, intraoperative blood loss, and perioperative complication rate.