In conclusion, this case demonstrates the effectiveness of laparoscopy in acute abdomen cases in which a specific preoperative diagnosis cannot be made. Aspiration of the fluid and drainage comprise a sufficient therapy if a focus cannot be found. Postoperative somatostatin use may be beneficial.
Objective: This survey study attempted to determine Turkish primary care physicians’ (PCP) knowledge, attitudes, and perceptions of obesity treatment and bariatric surgery. Moreover, the relationship between the duration of practice as a physician, and especially the indications for bariatric surgery and referral to surgery were investigated. Material and Methods: A survey of 27 questions was administered via social media and the internet using the SurveyMonkey platform. The physicians who responded to the survey were grouped based on the duration of working life. Among these groups, the responses to the questions about bariatric surgery were compared using univariate analysis. Results: A total of 1044 physicians responded to the survey. The number of physicians who strongly agreed that a PCP should play role in the treatment of obesity was 743 (71.1%). The most important reason for not undertaking this treatment was reported as the requirement for a multidisciplinary approach to obesity treatment (51.5%, n= 537). The percentage of those who thought that patients with a body mass index (BMI) above 40 kg/m2 should be referred to surgery was 72.3%,while the percentage of those referring patients with a BMI of 35-40 kg/m2 and comorbidities to surgery was 53.3%, and the percentage of those referring patients with a BMI of 35-40 kg/m2 and uncontrolled diabetes to surgery was 35.9%. Physicians who were new to the profession were found to evaluate surgical indications more positively (p< 0.05). Conclusion: This study found that PCPs in Turkey had a basic knowledge of obesity treatment and were willing to treat and follow up these patients. However, it was observed that they could not adequately focus on this issue due to the requirement for a multidisciplinary approach to the disease and the workload. It was found that the young physiciansð level of knowledge of bariatric surgery was higher, but their attitudes towards patient referral were similar.
Laparoscopic sleeve gastrectomy is used increasingly for obesity treatment. The most important complications of this procedure are bleeding and staple line leak. In this article, a 44-year-old female patient who developed a leak at the gastro-oesophageal junction following a revision laparoscopic sleeve gastrectomy is presented. The leak was recognized by computerized tomography and fluoroscopy that were performed during endoscopy. A fully expandable covered stent was inserted to the leak site. The stent was removed endoscopically after three weeks and the fistula healed completely. Early use of stents is an effective treatment method in leaks that have developed after sleeve gastrectomy.Key Words: Sleeve gastrectomy, staple line leak, oesophageal stent INTRODUCTIONLaparoscopic sleeve gastrectomy (LSG) is increasingly being applied in the surgical treatment of morbid obesity in recent years. As compared to methods such as gastric bypass or biliopancreatic diversion, laparoscopy is easy to apply and does not cause a major change in body physiology, successful results both in the short and medium term follow-up are the most important factors in this increase. The overall complication rate of LSG is reported as 0-24%, staple line leakage rate as 0 to 5.3% and the mortality rate as 0.39% (1, 2).Both the diagnosis and treatment of these leaks differ from other leaks. Early surgery, radiological drainage, stents, sutures, clip application, and various methods like tissue adhesive and t-tube external drainage have been defined in its treatment. In this case report, a patient who developed a leak following a secondary obesity surgery and was treated by endoscopic stenting alone was presented along with the literature. CASE PRESENTATIONA female patient with a body mass index (BMI) of 39.1 (length: 1.59, weight: 99) was admitted to hospital for obesity surgery due to weight gain. The patient previously underwent a laparoscopic gastric banding six years ago, but the band had been removed with open surgery one year later due to band infection. After removal of the gastric band, the patient stated rapid weight gain. She did not have any concomitant disease. Her physical examination was unremarkable except a midline supra-umbilical incision and port-site scars. The patient was planned to undergo LSG.The operation was performed in the French position, with the surgeon standing between the legs. The pneumoperitoneum was created by the open approach. Two 15 mm, one 10 mm, and one 5 mm ports and a 30 0 camera were used. There were intra-abdominal adhesions secondary to previous abdominal operations. All adhesions were separated by an ultrasonic dissector (Harmonic®, EthiconJohnson&Johnson). The greater curvature was dissected free of its vessels. The sleeve gastrectomy was completed by using five gold cartridges (Echolon Flex TM 60 mm, Ethicon-Johnson & Johnson), over a 42 F dilator, approximately 4 cm proximal to the pylorus. 2/0 silk serosal sutures were placed over the proximal staple lines. A leak test was performed with meth...
Objectives: To investigate the efficacy of bilateral 4-quadrant laparoscopic-assisted transversus abdominis plane (BLTAP) block in laparoscopic cholecystectomy (LC).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.