IntroductionGastric bypass is today the most frequently performed bariatric procedure, but,
despite of it, several complications can occur with varied morbimortality.
Probably all bariatric surgeons know these complications, but, as bariatric
surgery continues to spread, general surgeon must be familiarized to it and its
management. Gastric bypass complications can be divided into two groups: early and
late complications, taking into account the two weeks period after the surgery.
This paper will focus the late ones.MethodLiterature review was carried out using Medline/PubMed, Cochrane Library, SciELO,
and additional information on institutional sites of interest crossing the
headings: gastric bypass AND complications; follow-up studies AND complications;
postoperative complications AND anastomosis, Roux-en-Y; obesity AND postoperative
complications. Search language was English.ResultsThere were selected 35 studies that matched the headings. Late complications were
considered as: anastomotic strictures, marginal ulceration and gastrogastric
fistula.ConclusionKnowledge on strategies on how to reduce the risk and incidence of complications
must be acquired, and every surgeon must be familiar with these complications in
order to achieve an earlier recognition and perform the best intervention.
IntroductionGastric bypass is today the most frequently performed bariatric procedure,but,
despite of it, several complications can occur with varied morbimortality.
Probably all bariatric surgeons know these complications, but, as bariatric
surgery continues to spread, general surgeon must be familiarized to it and its
management. Gastric bypass complications can be divided into two groups: early and
late complications, taking into account the two weeks period after the surgery.
This paper will focus the early ones.MethodLiterature review was carried out using Medline/PubMed, Cochrane Library, SciELO,
and additional information on institutional sites of interest crossing the
headings: gastric bypass AND complications; follow-up studies AND complications;
postoperative complications AND anastomosis, Roux-en-Y; obesity AND postoperative
complications. Search language was English.ResultsThere were selected 26 studies that matched the headings. Early complications
included: anastomotic or staple line leaks, gastrointestinal bleeding, intestinal
obstruction and incorrect Roux limb reconstruction.ConclusionsKnowledge on strategies on how to reduce the risk and incidence of complications
must be acquired, and every surgeon must be familiar with these complications in
order to achieve an earlier recognition and perform the best intervention.
Since its appear
in the year 1997, when Drs. Cadiere and Himpens did the first robotic cholecystectomy in Brussels, not long after the first cholecystectomy, they performed the first robotic bariatric procedure. It is believed that robotically-assisted surgery’s most notable contributions are reflected in its ability to extend the benefits of minimally invasive surgery to procedures not routinely performed using minimal access techniques. We describe the 3 most common bariatric procedures done by robot. The main advantages of the robotic system applied to the gastric bypass appear to be better control of stoma size, avoidance of stapler costs, elimination of the potential for oropharyngeal and esophageal trauma, and a potential decrease in wound infection. While in the sleeve gastrectomy and adjustable gastric banding its utility is more debatable, giving a bigger advantage during surgery on patients with a very large BMI or revisional cases.
Background:Obesity represents a growing threat to population health all over the world. Laparoscopic sleeve gastrectomy induces alteration of the esophagogastric angle due to surgery itself, hypotony of the lower esophageal sphincter after division of muscular sling fibers, decrease of the gastric volume and, consequently, increase of intragastric pressure; that’s why some patients have reflux after sleeve. Aim:To describe a technique and preliminary results of sleeve gastrectomy with a Nissen fundoplication, in order to decrease reflux after sleeve. Method:In the current article we describe the technique step by step mostly focused on the creation of the wrap and it care. Results: This procedure was applied in a case of 45 BMI female of 53 years old, with GERD. An endoscopy was done demonstrating a hiatal hernia, and five benign polyps. A Nissen sleeve was performed due to its GERD, hiatal hernia and multiple polyps on the stomach. She tolerated well the procedure and was discharged home uneventfully 48 h after. Conclusion:N-sleeve is a feasible and safe alternative in obese patients with reflux and hiatal hernia when Roux-en-Y gastric bypass it is not indicated.
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