Adjustable Gastric Banding in an Ambulatory Surgery Center

Watkins, Brad M.; Montgomery, Kevin F.; Ahroni, Jessie H.; Erlitz, Marc D.; Abrams, R; Scurlock, James E.

doi:10.1381/0960892054621099

Cited by 40 publications

(49 citation statements)

References 8 publications

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“…The 2006 American Society of Anesthesiologists practice guidelines for perioperative management of patients with OSA were developed with the aim to help practitioners make rational decisions and provide optimal perioperative care to those patients (17). However, some practitioners do not consider appropriately treated as a contraindication for ambulatory LAGB (6,18). Such an approach is actually supported by this study that demonstrated similarities in non-ambulatory (39.1%) and ambulatory outcomes (37.4%) of patients with OSA (p=0.83).…”

Section: Discussionsupporting

confidence: 54%

“…Skilled surgeons require roughly 1 h of operative time for completion of LAGB (8,18). Reported conversion rates to an open procedure have ranged from 0% in private practice settings to 8% at academic institutions where residents are involved (6,7). A mean surgical time of 70 min with no conversions to an open procedure in the current study points towards a reliable surgical technique.…”

Section: Discussionmentioning

confidence: 67%

“…The success of ambulatory LAGB has been linked to the experience of surgeons and anaesthesiologists (2,6). Skilled surgeons require roughly 1 h of operative time for completion of LAGB (8,18).…”

Section: Discussionmentioning

confidence: 99%

“…Laparoscopic-adjustable gastric banding (LAGB) is a minimally invasive bariatric surgery with a low incidence of perioperative complications (2,3). Several trials have demonstrated that careful patient selection allows LAGB to be an ambulatory procedure (4)(5)(6)(7)(8)(9)(10). However, many of these prospective studies had small sample sizes with patients already preselected in observational trials.…”

mentioning

confidence: 99%

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Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Dupanovic¹,

Krebill²,

Dupanovic³

et al. 2017

Turk J Anaesth Reanim

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Objective: Morbidly obese patients are traditionally hospitalised following bariatric surgery. However, laparoscopic-adjustable gastric banding (LAGB) is amenable for ambulatory care. We hypothesised that the majority of patients can receive an ambulatory LAGB and that both surgical and anaesthetic perioperative factors will significantly affect non-ambulatory LAGB outcomes.Methods: Medical records of 201 consecutive LAGB patients performed at the University of Kansas Medical Centre during a 3-y period were reviewed. Demographic, medical, laboratory, anaesthetic, intraoperative and postoperative data were collected. Factors associated with non-ambulatory outcomes were identified and analysed using logistic regression, and a classification tree analysis was used to rank the descriptive model factor to the non-ambulatory outcome.Results: Average patient age was 43.4±11.4 years, and average body mass index was 48.2±10.3 kg m 2-1 . A total of 155 patients (77.1%; 95% confidence interval, 71%-83%; p<0.0001) were discharged home within 2-3 hours of surgery, whereas 36 stayed for 23 hours and 10 required hospital admission for 1-2 days. Increased surgical port numbers (p=0.007), ≥50% of total intraoperative fentanyl administered in the recovery room (post-anaesthesia care unit) for the treatment of postoperative pain (p=0.007) and a lack of prophylactic beta-blockade (p=0.001) were three factors associated with non-ambulatory outcomes. Obstructive sleep apnoea was not associated with a non-ambulatory outcome (p=0.83). Conclusion:The majority of patients received an ambulatory LAGB. Meticulous laparoscopic surgical technique with the least feasible number of access ports and multimodal analgesic technique aimed at reduction of postoperative opioid consumption are the most important factors for a successful ambulatory LAGB outcome.Keywords: Ambulatory surgery, bariatric surgery, laparoscopic surgery, outpatient surgery Abstract Address for Correspondence: Mirsad Dupanovic

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Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Dupanovic¹,

Krebill²,

Dupanovic³

et al. 2017

Turk J Anaesth Reanim

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“…23 Gastric banding procedures induce considerable weight loss in obese subjects. 24,25 Gastric bypass, the most frequent operation performed in USA, is more invasive and still more efficient, with satisfactory >60% EWL. 2,26 Biliopancreatic diversion of Scopinaro et al 27,28 is a mixed and complex operation that, in association with nutrient supplementation to avoid nutritional deficiency, has shown the most effectiveness in weight loss and permanent normalization of serum glucose, triglyceride, and cholesterol levels, with results maintained for >10 years follow-up.…”

Section: Discussionmentioning

confidence: 99%

Is Digital Image Plethysmographic (DIP) Acquisition a Valid New Tool for Preoperative Body Composition Assessment? A Validation by Dual-energy X-ray Absorptiometry

Lorenzo¹,

Servidio²,

Renzo³

et al. 2006

obes surg

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, by dual X-ray absorptiometry (DXA) and by digital image plethysmographic (DIP) acquisition with a digital camera. The clear-colored body of the subjects was automatically converted into a front and lateral red-shaped figure, and then through algorithms the 2 pictures were transformed into a nominal volume; body weight was then divided by the estimated volume, so that the body density could be obtained. DXA was used as a comparison to assess fat mass and fat-free mass. Radiation exposure was <0.6 mSv.Results: Significant positive correlation (R= 0.971, P<0.001) was found between data of body composition obtained by DXA and DIP.Conclusions: Body volume assessed using DIP or DXA did not differ. According to this validation study, DIP represents a new promising tool for clinical applications.

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Infection Control Practices in Ambulatory Surgical Centers

Barie¹

2010

JAMA

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Adjustable Gastric Banding in an Ambulatory Surgery Center

Abstract: LAGB has become an appropriate outpatient procedure in select patients.

Cited by 40 publications

References 8 publications

Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Perioperative Factors Affecting Ambulatory Outcomes Following Laparoscopic-Adjustable Gastric Banding

Is Digital Image Plethysmographic (DIP) Acquisition a Valid New Tool for Preoperative Body Composition Assessment? A Validation by Dual-energy X-ray Absorptiometry

Infection Control Practices in Ambulatory Surgical Centers

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