The BIB((R)) has been effective to temporarily control obesity, inducing an excess weight loss of approximately 48%. It was not associated with mortality and showed minimal risk of major complications.

Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications.

This novel endoscopic procedure is safe, feasible, and effective, avoiding re-operation, allowing early oral feeding and discharge.

No abstract

BackgroundBariatric surgery, especially Roux-en-Y gastric bypass is an effective treatment for refractory morbid obesity, causing the loss of 75% of initial excess weight. After the surgery, however, weight regain can occur in 10-20% of cases. To help, endoscopic argon plasma coagulation (APC) is used to reduce the anastomotic diameter. Many patients who undergo this treatment, are not always familiar with this procedure and its respective precautions.AimThe aim of this study was to determine how well the candidate for APC understands the procedure and absorbs the information provided by the multidisciplinary team.MethodWe prepared a questionnaire with 12 true/false questions to evaluate the knowledge of the patients about the procedure they were to undergo. The questionnaire was administered by the surgeon during consultation in the preoperative period. The patients were invited to fill out the questionnaire.ResultsWe found out that the majority learned about the procedure through the internet. They knew it was an outpatient treatment, where the anesthesia was similar to that for endoscopy, and that they would have to follow a liquid diet. But none of them knew that the purpose of this diet was to improve local wound healing.ConclusionBariatric patients who have a second chance to resume weight loss, need continuous guidance. The internet should be used by the multidisciplinary team to promote awareness that APC will not be sufficient for weight loss and weight-loss maintenance in the long term. Furthermore, there is a need to clarify again the harm of drinking alcohol in the process of weight loss, making its curse widely known.

Introduction: Although it has received several criticisms, which is considered to be the most effective method used for global assessment of morbid obesity surgical treatment, still needs to be updated. Objective: Critical analysis of BAROS constitution and method. Method : BAROS as headings was searched in literature review using data from the main bariatric surgery journals until 2009. Results: Where found and assessed 121 papers containing criticisms on BAROS constitution and methodology. It has some failures and few researches show results on the use of this instrument, although it is still considered a standard method. Several authors that used it found imperfections in its methodology and suggested some changes addressed to improving its acceptance, showing the need of developing new methods to qualify the bariatric surgery results. Conclusion: BAROS constitution has failures and its methodology needs to be updated.

Enteral nutrition is the preferred route for nutritional support compared with parenteral nutrition if the gastrointestinal tract is functionally preserved. Long-standing nasogastric or nasoenteric feeding tubes are not well tolerated. Alternative routes are gastrostomy and jejunostomy. Percutaneous endoscopic gastrostomy/jejunostomy or those guided by fluoroscopy, sonography or tomography should be the first choices. Laparoscopy or laparotomy gastrostomy/jejunostomy routes should be reserved for specific situations. Insufflation of the stomach with air or saline solution facilitates the placement of nasoenteric feeding tubes or percutaneous sonographic-guided gastrostomy. The gastrostomy button is a safe and aesthetic alternative, at least in children. Comparison between percutaneous endoscopic gastrostomy and surgical gastrostomy performed either via laparotomy or laparoscopy favours the first in terms of costs and risks. Whenever associated intra-abdominal procedures or anatomic difficulties arise, a laparoscopic or an open access becomes necessary. Complications with feeding tubes are not uncommon and should be promptly recognized and treated.

Obesidade hipotalâmica pode ocorrer em humanos e pode ser reproduzida, experimentalmente, por lesão do VMH em ratos. Esta obesidade pode ser revertida por vagotomia troncular (VT), devido à redução da ingestão alimentar e da insulinemia mediada pelo nervo vago. Experimentalmente, a injeção de MSG causa lesão em nível de ARC. O objetivo deste trabalho é avaliar os efeitos do MSG em ratos e se VT os altera. Estudou-se 52 ratos Wistar machos, divididos em dois grupos de 26 animais, um submetido à injeção de MSG na fase neonatal e outro à de solução salina. Aos 30 dias de vida, após nova divisão, obteve-se: grupo MSG, submetido à VT (VTMSG), e outro à laparotomia (LAPMSG); grupo SALINA, submetido à VT (VTSAL), e outro à laparotomia (LAPSAL). Obteve-se peso, CNA e índice de Lee. O consumo alimentar foi obtido dos 30 aos 90 dias de vida. Aos 90 dias, após eutanásia, mensurou-se peso, CNA, índice de Lee e gordura perigonadal. Análise estatística foi realizada pelo "t de Student". Constatou-se que o MSG provoca redução do CNA e aumento do índice de Lee aos 30 dias de vida, e provoca redução do peso e do CNA, aumento do índice de Lee e da gordura perigonadal aos 90 dias e aumento do consumo alimentar dos 30 aos 90 dias de vida. A VT provoca redução do peso, do índice de Lee e da gordura perigonadal, e tendência à redução do CNA no rato injetado com MSG. A VT provoca redução de consumo alimentar nos primeiros 30 dias de pós-operatório, mas com tendência a maior consumo nos 30 dias subseqüentes. Conclui-se que o MSG injetado na fase neonatal provoca aumento do consumo alimentar e da adiposidade e causa redução da estatura e do peso do animal dos 30 aos 90 dias de vida. E que a VT, realizada aos 30 dias de vida, provoca redução do consumo alimentar nos primeiros 30 dias de pós-operatório, da adiposidade e do peso.