Current Endoscopic/Laparoscopic Bariatric Procedures

Mathus-Vliegen, Elisabeth M. H.; Dargent, J.

doi:10.1007/978-3-319-90074-2_2

Cited by 7 publications

(8 citation statements)

References 232 publications

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“…At present, the number of patients who undergo such surgery is high. Mathus-Vliegen reported that the loss of gastric fixation along its previous natural axis along the greater curve could also be an explanation for early postoperative nausea, retching, vomiting, and reflux symptoms [18]. Regarding GERD, LSG is associated with the improvement and/or excitation of GERD in obesity [19,20].…”

Section: Discussionmentioning

confidence: 99%

Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy

Abou-Ashour

2021

OBES SURG

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Background Laparoscopic sleeve gastrectomy (LSG) has become a single-step operation for the management of severe obesity. A statistically significant number of participants who undergo this procedure experience nausea, vomiting, and reflux symptoms early after the operation. The objectives of this study were to measure the positive or negative effect of gastropexy on reducing distressing postoperative LSG-related gastrointestinal symptoms. Patients and Methods This was a comparative randomized study conducted from January 2018 to January 2021. The study was carried out in the general surgery department at Menoufia University Hospital, Menoufia Faculty of Medicine in Egypt. Two hundred participants were included randomly during this trial. The participants were divided into two groups, with 100 patients in each group. Patients in group A underwent gastropexy, and patients in group B underwent LSG without gastropexy. Results There was no significant difference between the groups in age or sex (p > 0.05). There was no significant difference in the length of hospital stay (p > 0.05). There was a significant difference between the two groups regarding nausea, vomiting, reflux symptoms, and the amount and frequency of antiemetics used (p < 0.001). There was also a significant difference in hospital readmissions (p < 0.05) and in clinic visits during the postoperative period. Conclusions Patients who underwent gastropexy showed a significant reduction in antiemetic consumption and a significantly lower incidence of postoperative nausea, vomiting, gastroesophageal reflux disease symptoms and gastric torsion than those who did not undergo gastropexy. Graphical abstract

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Section: Discussionmentioning

confidence: 99%

Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy

Abou-Ashour

2021

OBES SURG

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“…In recent years, endoluminal interventions, such as Endoscopic Sleeve Gastroplasty (ESG), and devices have been developed with the aim to make safer and more accessible bariatric procedures, also to people with morbid obesity and obesity-related pathologies. However, the lack of standardization, the greater technical difficulty, the long-lasting and the unknown long-term efficacy have slowed down the spread of ESG techniques [ 30 , 31 ]. Bariatric surgery is mainly defined on experiential bases and surgeons’ practice, and a more rational approach is still challenging.…”

Section: In Silico Analysis Of Surgical Procedures: Case Studiesmentioning

confidence: 99%

Computational Biomechanics: In-Silico Tools for the Investigation of Surgical Procedures and Devices

2020

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Biomechanical investigations of surgical procedures and devices are usually developed by means of human or animal models. The exploitation of computational methods and tools can reduce, refine, and replace (3R) the animal experimentations for scientific purposes and for pre-clinical research. The computational model of a biological structure characterizes both its geometrical conformation and the mechanical behavior of its building tissues. Model development requires coupled experimental and computational activities. Medical images and anthropometric information provide the geometrical definition of the computational model. Histological investigations and mechanical tests on tissue samples allow for characterizing biological tissues’ mechanical response by means of constitutive models. The assessment of computational model reliability requires comparing model results and data from further experimentations. Computational methods allow for the in-silico analysis of surgical procedures and devices’ functionality considering many different influencing variables, the experimental investigation of which should be extremely expensive and time consuming. Furthermore, computational methods provide information that experimental methods barely supply, as the strain and the stress fields that regulate important mechano-biological phenomena. In this work, general notes about the development of biomechanical tools are proposed, together with specific applications to different fields, as dental implantology and bariatric surgery.

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“…For those who do not respond to medical therapy or are not or not yet surgical candidates or refuse surgery because of its invasiveness and fear of complications, less invasive endoscopic treatments might look attractive. These treatments, also called Endoscopic Bariatric and Metabolic Therapy, include intragastric balloon systems 4–8 . Promising long‐term weight maintenance data have been reported with this method 9…”

Section: Introductionmentioning

confidence: 99%

“…However, the exact mechanism by which intragastric balloons induce weight loss is still not known. Intragastric balloons are hypothesized to mediate satiety peripherally , by being a physical impediment of food intake, by reducing the gastric capacity and by delaying gastric emptying, and centrally , by activating gastric stretch receptors that transmit signals via afferent vagal nerves, the solitary tract and paraventricular nuclei, to the ventromedial and lateral hypothalamus 4 20–22 Short‐term satiety is primarily affected by gastric distension and gastric volume, that is, by the weight and volume of the food rather than its energy content 22 …”

Section: Introductionmentioning

confidence: 99%

“…After the intake of a meal the gastrointestinal tract releases regulatory peptide hormones contributing to the feeling of satiety 20 . The release of postprandial hormones is principally mediated by two mechanisms; (1) by the contact of nutrients, with its different physiochemical properties with receptors in the GI tract; and (2) by the mechanical distension of the stomach leading to increased neural afferent firing in the vagal nerve, affecting feeding‐related areas in the brain, including the hypothalamus 4 21 …”

Section: Introductionmentioning

confidence: 99%

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Weight loss with or without intragastric balloon causes divergent effects on ghrelin cell expression

Mathus-Vliegen

Spångéus

Walter

et al. 2021

Obesity Science & Practice

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Objective: The mechanism of action of intragastric balloons in the treatment of obesity is not fully understood. One of the hypotheses is that balloons might have an effect on the fundus, the area of ghrelin production.Methods: Participants were randomized to a 13-week period of sham or balloon treatment followed by a 13-week period of balloon therapy in everyone. Blood samples for ghrelin levels were taken in the fasting state and after a breakfast at the start, after 13 and 26 weeks. Biopsies for ghrelin cell immunohistochemistry were taken from the fundus at endoscopy. Results:Seven participants entered the balloon-balloon (BB) group and 11 the sham-balloon (SB) group. Despite a considerable weight loss, a median À 17.9 kg (interquartile ranges À 23.8 to À 0.5) in the BB group and À 18.3 kg (À 22.7 to À 14.7) in the SB group, fasting ghrelin and meal-induced ghrelin response did not change.In the SB group, the number of ghrelin cells increased significantly (p 0.001) from 110.6 (83.6-118.9) to 160.2 (128.5-223.0) while on sham treatment and returned to initial levels, 116.3 (91.7-146.9) (p 0.001), when they received their first balloon.No significant changes in ghrelin cell numbers were observed in the BB group. Conclusion:In participants without a balloon, weight loss induced an increase in ghrelin cell numbers in the fundus, which was annulled by the subsequent placement of a balloon. The effect of a balloon might be explained by effects on ghrelin cell numbers or ghrelin cell activity.

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Current Endoscopic/Laparoscopic Bariatric Procedures

Cited by 7 publications

References 232 publications

Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy

Impact of Gastropexy/Omentopexy on Gastrointestinal Symptoms after Laparoscopic Sleeve Gastrectomy

Computational Biomechanics: In-Silico Tools for the Investigation of Surgical Procedures and Devices

Weight loss with or without intragastric balloon causes divergent effects on ghrelin cell expression

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