Aortic rupture during reoperative bariatric surgery

Hostiuc, Sorin; Dragoteanu, Constantin; Asavei, Victor; Negoi, Ionuț

doi:10.5935/1678-9741.20150051

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…Non-trocar iatrogenic injury to the aorta has also been reported during LAGB revision2; however, to our knowledge, this is a unique report of aortic encirclement by LAGB. Complications related to LAGB surgery resulting in small bowel ischaemia (as in this case), bowel perforation or erosion with intestinal or biliary obstruction have been previously reported in the literature,3–7.…”

Section: Discussionmentioning

confidence: 71%

Unique complication of laparoscopic adjustable gastric band? A misplaced band encircling the abdominal aorta

2018

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In the recent past, laparoscopic adjustable gastric bands (LAGBs) have been used extensively in bariatric surgery. Despite questionable long-term efficacy, they are generally safe and reversible. We report a possibly unique presentation of a potential hazard of the insertion technique; a misplaced LAGB encircling the abdominal aorta, which was confirmed radiologically and on operative removal of the gastric band. This is a dramatic complication of LAGB, representing an important anatomical hazard for gastric band insertion.

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Section: Discussionmentioning

confidence: 71%

Unique complication of laparoscopic adjustable gastric band? A misplaced band encircling the abdominal aorta

2018

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“…Obezite, çeşitli hastalıklara (örneğin diabetes mellitus, kalp-damar hastalıkları ve metabolik hastalıklar) yol açması, yaşam kalitesini bozması, öngörülen yaşam süresini kısaltması ve tedavisi külfetli olması nedeniyle önemli kronik-kompleks bir hastalıktır. 1,7,8 Obezite neticesinde sıklıkla kardiyovasküler ve sistemik hastalıkların (diabetes mellitus, hipertansiyon vb.) görülmesiyle birlikte, malignensi riskini artırdığı dahi bildirilmiştir.…”

Section: Discussionunclassified

Investigation of Autopsy Findings of Obesity Surgery Related Deaths: Retrospective Original Research

TUNÇEZ¹,

ERSEN²,

Atan³

et al. 2022

Turkiye Klinikleri J Foren Sci Leg Med

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Çalışmamızda, obezite cerrahisi sonrası meydana gelen ölümleri ve otopsi bulgularını yapılan adli otopsiler üzerinden inceleyerek, bu veriler ışığında literatüre katkı sağlamayı amaçladık. Gereç ve Yöntemler: Çalışmamızda, Adli Tıp Kurumu İzmir Grup Başkanlığında 2010-2020 yılları arasında yapılan tüm otopsiler incelenerek, obezite cerrahisi sonrası otopsisi yapılan ölümler çalışmaya dâhil edildi. Elde edilen veriler SPSS 22 programıyla analiz edildi ve incelendi. Bulgular: Adli Tıp Kurumu İzmir Grup Başkanlığınca 2010-2020 yılları arasında yapılan toplam 25.349 otopsiden 7'sinin obezite cerrahisi sonrası otopsi yapıldığı, bunların 5'i sleeve gastrektomi, 1'i Roux-en-Y ve 1'i de total gastrektomi+Roux-en-Y bariyatrik cerrahi operasyonu geçirdiği tespit edildi. Olgularımızın ölüm sebepleri irdelendiğinde; 2 olgunun koroner arter hastalığı sonucunda öldüğü kanaatine varılırken, 1 olgunun bağırsak perforasyonu, 2 olgunun sepsis, 1 olgunun pulmoner emboli ve 1 olgunun superior mezenterik arter embolisi/superior mezenterik ven trombüsü ortak etkisi ile öldüğü tıbbi kanaatine varılmıştır. Sonuç: Postoperatif dönemde meydana gelen ölümler, tıbbi soruların yanı sıra hukuki olarak da malpraktis davaları açısından önemli soruları gündeme getirmektedir. Bu noktada detaylı ve cerrahi branşların da destek vereceği bir adli otopsi ile hukuki ve tıbbi açıdan olası sorular kolaylıkla yanıt bulacak ve uygulanan tıbbi-cerrahi tedavi yöntemlerinin halk sağlığı açısından sorgulanması, fayda-zararlarının tartışılmasıyla elde edilen sonuçlar literatüre katkı sağlayacaktır.Anah tar Ke li me ler: Obezite; bariyatrik cerrahi; otopsi ABS TRACT Objective: In this study, it is aimed to contribute to the literature by examining the deaths and autopsy findings after obesity surgery through forensic autopsies executed. Material and Methods: In this study, all autopsies performed between 2010-2020 years at the Forensic Medicine Institute İzmir Group Presidency were examined and deaths autopsied after bariatric surgery were included in the study. The obtained data were analyzed with the SPSS 22 program. Results: 7 out of 25,349 cases performed in The Council of Forensic Medicine İzmir Group Presidency 2010-2020 were death cases after bariatric surgery in the last decade. The surgeries were 5 sleeve gastrectomy, 1 Roux-en-Y and 1 total gastrectomy+Roux-en-Y bariatric surgery. When the causes of death examined, it was concluded that 2 cases died as a result of coronary artery disease, 1 case died of intestinal perforation, 2 cases because of sepsis, 1 case result of pulmonary embolism and 1 case reasoned of mix effect of superior mesenteric artery embolism and superior mesenteric vein thrombus. Conclusion: Deaths occurring in the post operative period raise important questions in terms of legal malpractice cases, as well as medical questions. Forensic autopsies those will be supported surgical specialists and perfomed causiously, will answer possible legal and medical questions easier. The results obtained by examining the applied medical-surgical...

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“…reported their experience of gastric band removal for gastric bleeding, finding dense fibrous tissue requiring extensive dissection, subsequently resulting in inadvertent aortic injury and subsequent death. 3 Possible erosion and fibrous scarring secondary to presence of a foreign body around the supracoeliac aorta should be considered pre-operatively and steps taken to address the risk of major haemorrhage prior to gastric band removal.…”

Section: Discussionmentioning

confidence: 99%

Aorta, the Innocent Bystander of Bariatric Banding

Pang

Lamb

Falah

2021

EJVES Vascular Forum

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Introduction Laparoscopic gastric banding (LAGB) is a common bariatric operation performed for obesity. Complications of LAGB commonly evolve around device malfunction and physiological changes secondary to the gastric banding. Complications of LAGB involving the aorta are rare. A case of gastric band misplacement around the aorta and subsequent successful retrieval of the misplaced device is reported. Report A 45 year old obese woman presented as an emergency with food bolus obstruction secondary to gastric banding inserted 10 years previously. Investigations revealed that her gastric band was misplaced around both the oesophagus at the level of the gastro-oesophageal junction and the descending thoracic aorta at the level of T12. Successful and safe retrieval of the misplaced device is reported electively via a two staged approach: first covering the segment of supra-coeliac aorta at the level of the gastric band with a thoracic aortic stent graft (TAG), and, second, assessing for any oesophageal injury via endoscopy and finally extracting the misplaced device via laparoscopy. A Gore C-TAG device size 26 mm × 100 mm was successfully implanted percutaneously via unilateral femoral access during her first stage procedure. Her gastric band was safely retrieved during her second stage procedure with no complications. She recovered well post-operatively. Discussion Complications of LAGB involving the aorta are rare but potentially life threatening. Multidisciplinary pre-operative planning is necessary for safe removal of the gastric band.

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Aortic rupture during reoperative bariatric surgery

Cited by 3 publications

References 8 publications

Unique complication of laparoscopic adjustable gastric band? A misplaced band encircling the abdominal aorta

Unique complication of laparoscopic adjustable gastric band? A misplaced band encircling the abdominal aorta

Investigation of Autopsy Findings of Obesity Surgery Related Deaths: Retrospective Original Research

Aorta, the Innocent Bystander of Bariatric Banding

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