Laparoscopic gastric reduction surgery

The clinical effects of laparoscopy in the pulmonary function of obese patients have been poorly investigated in the past. A systematic review was undertaken, with the objective to identify published evidence on pulmonary complications in laparoscopic surgery in the obese. Outcome measures included pulmonary morbidity, pulmonary infection and mortality. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) with 95% confidence interval (CI). A total of 6 randomized and 14 observational studies were included, which reported data on 185,328 patients. Pulmonary complications occurred in 1.6% of laparoscopic and in 3.6% of open procedures (OR 0.45, 95% CI 0.34-0.60). Pneumonia was reported in 0.5% and in 1.1%, respectively (OR 0.45, 95% CI 0.40-0.51). Available evidence suggests lower pulmonary morbidity for laparoscopic surgery in obese patients; further quality studies are however necessary to consolidate these findings.

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“…A total number of 20 articles entered the meta-analysis models (fig. 1) [24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43]. …”

Section: Resultsmentioning

confidence: 99%

Laparoscopic versus Open Obesity Surgery: A Meta-Analysis of Pulmonary Complications

Antoniou¹,

Antoniou²,

Koch³

et al. 2015

Dig Surg

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“…The first reconstruction laparoscopic gastrectomy Billroth II for the treatment of cancer was performed by Kitano et al 9 , in 1992 and published in 1994. In Belgium, in June 1993, Azagra et al 1 , 2 , performed the first total gastrectomy for treatment of gastric cancer and in 1999, published his experience with 13 patients, concluding that laparoscopy for treatment of gastric cancer is feasible, oncologically safe and should be used for patients with early lesions, reserving the combined surgery (video-assisted) to more advanced lesions. In 2006, this author also participated in a multicenter study, in which were analyzed 130 patients with gastric adenocarcinoma, followed by 49 months on average, and concluded that the laparoscopic gastrectomy with any type of lymphadenectomy and even as a palliative method is a safe procedure, with acceptable mortality rates in patients with advanced gastric cancer, usually in unfavorable clinical conditions, and that laparoscopy for localized disease, is equivalent to open surgery with the same oncological outcomes and the advantages already mentioned for laparoscopy 7 .…”

Section: Introductionmentioning

confidence: 99%

Step-by-step esophagojejunal anastomosis after intra-corporeal total gastrectomy for laparoscopic gastric cancer treatment: technique of "reverse anvil"

Lacerda¹,

Bertulucci²,

Oliveira³

2014

ABCD, arq. bras. cir. dig.

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BackgroundThe laparoscopic gastrectomy is a relatively new procedure due mainly to the difficulties related to lymphadenectomy and reconstruction. Until the moment, technique or device to perform the esophagojejunal anastomosis by laparoscopy is still a challenge. So, a safe, cheap and quickly performing technique is desirable to be developed.AimTo present technique proposed by the authors with its technical details on reconstruction with "reverse anvil".MethodAfter total gastrectomy completed intra-corporeally, the reconstruction starts with the preparation of the intra-abdominal esophagus cross-section next to the esophagogastric transition of 50%. A graduated device is prepared using Levine gastric tubes (nº. 14 and 10), 3 cm length, connected to the anvil of the circular stapler (nº. 25) with a wire thread (2-0 or 3-0) of 10 cm, which is connected to end of this device. The whole device is introduced in reverse esophagus. The esophagus is amputated and the wire is pulled after previous transfixation in the distal esophagus and the anvil positioned. The jejunal loop is sectioned 20-30 cm from duodenojejunal angle, and the anvil put in the jejunal loop and connect previously in the esophagus. Linear stapler (blue 60 mm) is used to close the opening of the jejunal loop.ConclusionThe "reverse anvil" technique used by the authors facilitated the transit reestablishment after total gastrectomy, contributing to obviate reconstruction problems after total gastrectomy.

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“…Laparoscopic surgery is now a widely accepted treatment modality in many fields of general surgery [1-6]. The creation of pneumoperitoneum and the safe placement of the initial trocar are considered very important steps in laparoscopic surgery.…”

Section: Introductionmentioning

confidence: 99%

A comparison of the periumbilical incision and the intraumbilical incision in laparoscopic appendectomy

2012

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PurposeThe intraumbilical incision is being used more frequently, with increasing cases of single incision laparoscopic surgery. Since the umbilicus is deeper than the surrounding wall, it has abundant bacteria. No study has compared the adverse outcomes of periumbilical and intraumbilical incisions. We analyzed the wound complication rates of perforated appendicitis patients according to the types of umbilical incision.MethodsA retrospective review was done of 280 patients with perforated appendicitis. One hundred fifty nine patients were treated with the intraumbilical incision, and 121 patients were treated with the periumbilical incision. We compared the perioperative outcomes according to each laparoscopic incision.ResultsThere was no difference in operation time, postoperative hospital stay and analgesic requirement between the two groups. One case in the intraumbilical group (0.6%) and three cases in the periumbilical group (2.5%) developed wound infections. The umbilical complication rate showed no difference.ConclusionThe wound complication rate of intraumbilical and periumbilical incisions are not different. Although this retrospective study has inherent limitations, the intraumbilical incision seems to be a safe and feasible alternative for the periumbilical incision that can be easier to perform, with better cosmetic results.

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Laparoscopic gastric reduction surgery

Cited by 57 publications

References 10 publications

Laparoscopic versus Open Obesity Surgery: A Meta-Analysis of Pulmonary Complications

Laparoscopic versus Open Obesity Surgery: A Meta-Analysis of Pulmonary Complications

Step-by-step esophagojejunal anastomosis after intra-corporeal total gastrectomy for laparoscopic gastric cancer treatment: technique of "reverse anvil"

A comparison of the periumbilical incision and the intraumbilical incision in laparoscopic appendectomy

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