roux en y anastomosis

..This chaper demonstrates the use of preoperative preparation, and a meticulous surgical technique using the linear stapler, to perform a combined total of more than 1800 cases...

..Roux-en-Y gastric bypass (RYGBP) is the preferred operation for the treatment of morbid obesity by many surgeons. Hereby we present the process by which laparoscopic RYGBP (LRYGBP) developed at our institution...

..Following weight loss there is a high cure rate for diabetes and sleep apnea, with significant improvement in other complications of obesity such as hypertension and osteoarthritis...

..We used these techniques to determine which of the potential risk factors had the greatest impact on adverse outcomes following gastric bypass surgery...

..CONCLUSION: Upper GI complications that required intervention occurred in 9.5% of patients. CT and upper GI series can depict most major complications...

..Thus, for patients in the United States, Lap RYGBP may become the preferred weight-reduction procedure. The value of hand-assisted bariatric procedures and laparoscopic malabsorption procedures must await further study...

..The purpose of this study was to determine the effect of operative experience on perioperative outcomes for laparoscopic Roux-en-Y gastric bypass (LGB)...

..Endoscopic balloon dilatation can be offered as a first-line treatment for gastrojejunal anastomotic strictures. Perforation is a potential complication of this treatment and may necessitate surgical intervention...

..The purpose of this study was to compare the effect of short and long limb lengths in patients with BMI<50...

..CONCLUSION: Endoscopic balloon dilation is a safe and effective treatment option for GJ stricture. Improved weight loss occurred for patients with stricture requiring dilation...

..We hypothesized that this practice is unreliable...

..Gastroesophageal reflux disease and age were each shown to be statistically significant independent predictors of stricture following laparoscopic gastric bypass...

..Roux-en-Y gastric bypass is the most frequently performed bariatric surgery for morbid obesity. Gastrojejunal anastomotic strictures are a relatively frequent postoperative complication...

..This study was performed to evaluate the safety and short-term efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) for morbid obesity and to describe the relation between learning curve and short-term outcomes...

..An analysis of patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) may identify factors predictive of complication and of suboptimal weight loss...

..Endoscopic balloon dilation is a safe and effective option in the management of anastomotic stricture following laparoscopic GBP...

..The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed...

..Gastrojejunal anastomotic strictures develop in 4.7 to 27% of patients undergoing laparoscopic RYGBP. This paper details two endoscopic techniques for dilating gastrojejunal anastomotic strictures...

..However, these differences may reflect the learning curve because these techniques were used early in our experience. Lower postoperative stricture and wound infection rates seem to be the primary benefits of the HSA technique...

..Revisional bariatric surgery can be approached laparoscopically and with acceptable morbidity comparable to patients whose revision is approached open...

..Surgical drains facilitate the non-operative management of such anastomotic leaks. Planned early UGI and surgical drains minimize the morbidity of anastomotic leaks after bariatric surgery...

..Since our initial report, several groups throughout the world have preformed the gastric bypass laparoscopically, with various modifications...

..The perforation was treated with neck exploration and drainage. We discuss the mechanism of injury and alternative method for placement of the gastric anvil...

..We histologically and mechanically analyzed circular- stapled anastomoses with and without bioabsorbable staple-line reinforcement (SeamGuard, W. L. Gore & Associates, Flagstaff, AZ) in a porcine model...

..The objective of this study was to report the incidence of stomal strictures after LRYGB in our institution and report our experience with their management by endoscopic balloon dilatation...

..This case report serves to demonstrate that radical gastrectomy can be safely performed after CABG using the RGEA, and that gastric cancer will progress in spite of SSM therapy...

..The purpose of this study was to compare the complication rate of GJ performed with the 21- and 25-mm circular staplers...

..The gastrojejunostomy performed during Roux-en-Y gastric bypass (RYGBP) operations has technical variability with different outcomes and complication-rates immediate postoperatively and at long-term follow-up...

..On this basis, strong consideration should be given to the routine use of CBSG staple line reinforcement in patients undergoing laparoscopic divided gastric bypass with a circular stapled gastrojejunal anastomosis...

..In this article, we present a patient with super/super obesity (61 kg/m2) who underwent Rouxen-Y gastric bypass using the laparoscopic approach...

..Surgeons early in their learning curve should avoid these high-risk patients to reduce complications...

..Proper evaluation of clinical signs and symptoms, early abdominal CT scan, and urgent operative intervention are mandatory to achieve a successful outcome...

..The technique described here preserves the anatomic construct of the operation but introduces the benefit of the laparoscopic approach...

..Placement of an anastomotic stent is a matter of debate and to our knowledge there is no study that compares the results between stenting and not stenting the anastomosis...

..Laparoscopic RYGB is safe and technically feasible in the super morbidly obese patient population...

..To determine the safety and efficacy of laparoscopic Roux-en-Y gastric bypass for the treatment of morbid obesity...

..Laparoscopic biliopancreatic diversion with duodenal switch is feasible, but needs further studies. CONCLUSIONS: Randomized controlled trials comparing the various laparoscopic operations are strongly needed...

..To evaluate the short-term outcomes for laparoscopic Roux-en-Y gastric bypass in 275 patients with a follow-up of 1 to 31 months...

..This effect is permanent and avoids the appearance of dysplasia or adenocarcinoma...

..This study illustrates our experience in laparoscopic Roux-en-Y gastric bypass (LRYGBP) using a new technique for creating the gastro-jejunostomy...

..High sensitivity makes CT the test of choice in patients with suspected complication after LRYGB. Routine radiological studies are not warranted...

..Overall morbidity and mortality, however, are not different. Long-term results regarding weight loss or weight maintenance are highly satisfactory, and comparable to those obtained after laparoscopic RYGBP as a primary operation...

..laparoscopic adjustable gastric banding. The advantages and disadvantages of laparoscopic adjustable gastric banding compared to laparoscopic GBP is discussed...

..We present our method and experience with the first 150 consecutive cases of laparoscopic RYGBP with a 2-m long biliopancreatic limb (BP-limb)...

..The aim of this study is to determine which approach is most cost effective, considering costs associated with the operation itself, perioperative complications, and income lost during convalescence...

..HPVG is a potentially life-threatening condition due to its etiology, with a global survival rate of <25%. We present a case of gastro-jejunal anastomotic leak associated with HPVG after LRYGBP...

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..Robotic surgery promises to extend the capabilities of the minimally invasive surgeon. The aim of this study was to examine the feasibility of robotic surgery in the setting of laparoscopic gastric bypass...

..We present our experience with revision of antireflux procedures to LRYGBP in obese patients with recurrent GERD, weight gain or a combination of both and discuss the indications and technical considerations involved...

..Laparoscopic Roux-en-Y gastric bypass (RYGB) has become an established treatment modality for morbid obesity. Our objective was to review the initial experience with laparoscopic (RYGB) for morbid obesity at our VA facility...

..CONCLUSION: Laparoscopic conversion of LAGB to RYGBP is a technically challenging procedure that can be safely integrated into a bariatric treatment program with good results. Short-term weight loss is very good...

..This study is a retrospective review of a cohort of such patients, to examine operative experience and response to surgical treatment...

..The goal of this study was to determine the safety and effectiveness of LRYGBP in these patients, and compare these results to patients with a BMI <60...

..Roux-en-Y gastric bypass (RYGBP) is usually considered as the procedure of choice for morbid obesity, but its use has been limited in Europe. It is not known whether results with European patients match those from the USA...

..This article presents the results for 2 years of bariatric surgery in the authors' minimally invasive center and analyzes the results of the most used surgical techniques with regard to eating habits...

..The aim of this study was to review laparoscopic remnant gastrectomy (LRG) as a novel treatment option for this complication...

..We hypothesized that laparoscopic Roux-en-Y gastric bypass (LRYGB) can be performed in this patient population with acceptable morbidity and can achieve effective weight control...

..This technique provides an alternative method for completion of a laparoscopic gastric bypass in patients who would otherwise require more extensive surgery...

..Furthermore, we wish to examine the impact of Roux limb positioning ante- versus retrocolic and whether switching to running versus interrupted closure of the mesenteric defects created at surgery made any difference...

..With increasing popularity of laparoscopic RYGBP, we are likely to see more of this entity...

..Safety concerns about the laparoscopic technique have arisen in the literature with gastrojejunostomy leak rates of 5% or greater reported in several series...

..After recognition and intervention, the patient was successfully treated with thiamine replacement and parenteral nutrition...

..After the surgical procedure, she improved and required less medication. Because MG and morbid obesity require careful perioperative management in order to avoid complications, a multidisciplinary approach is recommended...

..This prospective, randomized trial compared the safety and effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGBP) and laparoscopic mini-gastric bypass (LMGBP) in the treatment of morbid obesity...

..A review of the audience's responses provides insight into the decision-making considerations of a population of laparoscopically oriented bariatric surgeons...

..In addition, the learning curve may be significantly shorter with the robotic procedure. Further experience is needed to understand the long-term advantages and disadvantages of the totally robotic approach...

..Today's weight-loss operations are safe, effective and potentially life-saving options for severely obese cardiology patients. This review describes weight-loss surgery procedures and their effects on cardiovascular risk factors...

..No differences in correction of co-morbidities or complication rates were found with preoperative weight loss in this study. Preoperative weight loss should be encouraged in patients undergoing bariatric surgery...

..Slow, but complete recovery occurred over nine months. We postulate that the head-up position in obese patients, without specific arm support, is a risk factor for brachial plexus injury...

..Also, insufficient weight loss is reported. We investigated whether revision to Roux-en-Y gastric bypass (RYGBP) is a safe and effective therapy for failed LAGB and for further weight loss...

..The BMI after 12 months was 28.4. The average basal weight was 74.2 Kg. Laparoscopic Roux-en-Y proximal gastric bypass is a safe and efficient technique for the treatment of morbid obesity...

..Revisional bariatric operations performed for weight loss failure are frequently associated with inconsistent weight reduction and serious perioperative complications...

..The diagnosis of SMA syndrome should be considered in bariatric surgery patients with rapid weight loss who develop atypical, recurrent obstructive symptoms not attributable to other common causes...

..Complications, length of stay, weight loss and costs were similar between the groups. Selection of anastomotic technique may be based on surgeon preference, operative time, and potential for serious complications...

..Gastric vascular anatomy renders the ventral aspect less suited for anastomotic construction. The lesser curvature has abundant blood supply that should preferably not be interfered with. Terminal anastomosis is a logical choice...

..BPD with RYGBP. The most common deficiencies encountered were of iron and vitamin B12. The incidence of hypoalbuminemia was negligible in both groups, with mean values above 4 g/dl...

..In addition, the many recent advances in methodology and pathophysiology are described in detail...

..Weight loss and control of obesity-related comorbidities are satisfactory. The LT results in fewer intensive care unit admissions and shorter length of stay than the OT...

..As this study showed, LRYGB achieves an excellent rate of weight loss and improvement in preoperative comorbidities with a minimal length of hospital stay and an acceptable complication rate...

..Length of stay averaged 1.2 days. Overall weight loss was 49% of excess body weight at 1 year after surgery. CONCLUSION: Laparoscopic Roux-en-Y gastric bypass is safe and effective in patients with a BMI of 70 or greater...

..Little information is available about the subgroup of patients with BMI > or = 60. The goal of this study was to evaluate the feasibility and safety of LRYGBP for patients with BMI > or = 60...

..Someone facing the need for comparison between gastric restrictive procedures could find it useful to have a general expression for weight loss after surgery...

..In our patient the weight loss was stable for 2 years, when the fistula was closed surgically to avoid chronic proton pump inhibitor medication for stomal ulcer...

..Laparoscopic surgery has been shown to reduce perioperative morbidity and to improve postoperative recovery for various procedures. Herein we present our results with laparoscopic RYGBP after an initial 2-year experience...

..There were 3 deaths in this series of patients, 2 attributable to anastomotic leak. CONCLUSIONS: A variety of complications can present after LRYGB. Laparoscopy is an excellent technique to treat these complications...

..CONCLUSION: Laparoscopic gastric bypass is a safe alternative in morbidly obese adolescents who have not responded to medical therapy...

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..There is no consensus regarding the optimal treatment of ventral hernias in patients who present for weight loss surgery...

..Despite the anatomic limitations, the porcine model was well-suited for skill development and evaluation of techniques for performing the LRYGBP operation...

..CONCLUSIONS: VBG-RGB is effective in producing superior weight loss in morbid and superobese patients and has a low mortality and morbidity. We recommend this procedure without reservations...

..The purpose of the SAGES Appropriateness Conference was to summarize the state of the art for open and laparoscopic operations for the morbidly obese...

..We report the results of a prospective comparison of vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) in a non-superobese population...

..The aim of this paper is to describe our surgical technique for laparoscopic gastric bypass (LGBP) and present the short-term results...

..The aim of this study was to determine the incidence of gallstone formation requiring cholecystectomy following a laparoscopic Roux-en-Y gastric bypass (LRYGBP)...

..Our prediction is that LAGB will not stand the test of time...

..The long-term efficacy of LAGB remains unproven, and evaluation by randomized controlled trials is recommended to define its merits relative to the comparator procedures...

..The CR test was easier to perform and preferred by the patients. We conclude that both tests provide valuable clinical information and that both tests should be available in the evaluation of postgastrectomy patients...

..Furthermore, they will serve as the baseline for future large scale longitudinal studies based on aggregate occurrence of severe cardiovascular events. ..

..3) To determine if cirrhotic human hepatocytes are resistant to TGFbeta-induced apoptosis via mechanisms that are operative in a murine model. ..

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..This proposal will define important, novel neural mechanisms regulating motor and absorptive function in the denervated gut. Selected aspects have translational value to clinical gut transplantation. ..

..Our findings may provide novel mechanisms that link regional obesity and insulin action. ..

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..With completion of the LDLT Cohort Study, the medical community will have a much clearer understanding of the impact of this important procedure on liver transplantation, LDLT recipients and LDLT donors. ..

..The ultimate goal is to use information from these studies for the development of obesity treatments that are less invasive than bariatric surgery and more effective than current pharmacotherapy. ..

..e., systemic and adipose-tissue inflammation) and adaptive immunity (i.e., islet-reactive T lymphocytes) in the anti-diabetic effects of RYGB, and evaluate the value of related metrics for future clinical trials. ..

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..parenteral nutrients, gastric distension, specific classes of macronutrients, leptin, fasting, and other meal-regulated gut peptides. 4) Is ghrelin effective as a drug to treat cancer anorexia in a rat model? ..

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..These experiments are directly relevant and will be clinically-applicable in understanding motor and absorptive aspects of the physiology of enteric function after intestinal transplantation...

..As external perturbations, they will use progressively increasing peripheral infusions of IL-1 and TRP, the serotonin precursor, as would result from a progressively growing tumor. ..

..Leibel and Dr. Wardlaw, are experienced in basic and clinical research. They are easily accessible, enthusiastic about my projects, and will facilitate my transition to status as an independent investigator. ..

..We will continue to seek counsel from our K08 mentors (Drs. David Brenner and Lola Reid) and use liberally the UNC Center for Gastrointestinal Biology and Disease for core facilities such as the Molecular Imaging Core. ..

..abstract_text> ..

..Identification of novel or differentially regulated hepatocyte growth control genes may provide information about altered growth control of cirrhotic hepatocytes. ..

..This proposal will define important new neural (and hormonal) mechanisms regulating motor and absorptive function in denervated gut. Selected aspects are pertinent to clinical gut transplantation. ..

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..g. by immunomodulatory cytokines or by cytokine antagonists. It is anticipated that the results will improve our understanding and management of cd and related autoimmune diseases. ..

..Adaptation to the human proteome and prospective validation shall allow noninvasive monitoring of fibrosis progression and regression in patients with liver diseases. ..