Laparoscopic Sleeve Gastrectomy for Morbid Obesity at a Veterans Affairs Medical Center

Skancke, Matthew; Schoolfield, Clint; Grossman, Robert; Kerns, Jennifer C.; Abel, Nicole; Brody, Fred

doi:10.1089/lap.2018.0002

Cited by 6 publications

(5 citation statements)

References 30 publications

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“…For the right-predominant type, the trocar beneath the right costal margin was utilized to retract the liver to expose the surgical field. The trocar between the observation trocar and the trocar beneath the right costal margin was used for gastrectomy and subsequent suturing 22 , 56 , 75 . The trocar beneath the left costal margin was used to drag the gastric wall to assist the application of the stapler.…”

Section: Discussionmentioning

confidence: 99%

Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis

Jiang

Zhang

Feng

et al. 2023

International Journal of Surgery

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Background: Conventional laparoscopic sleeve gastrectomy (CLSG) has been conducted in multiple centers for treating morbid obesity, however, there are no standard criteria for (1) placing the trocar; and (2) how many trocars should be used. Single-incision laparoscopic sleeve gastrectomy (SLSG), a newly emerged technique in 2008, has been proposed as an alternative to CLSG in recent years, however, there is no definite evidence for this. Materials and methods: A systematic literature search was performed using the PubMed, Embase, Web of Science, and Cochrane Library databases for laparoscopic sleeve gastrectomy cases from January 2006 to October 2022. We then summarized the trocar numbers and placement patterns among these studies. A meta-analysis was conducted to compare the difference between SLSG and CLSG in the perioperative and postoperative indices. Results: A total of 61 studies involving 20 180 patients who underwent laparoscopic sleeve gastrectomy for treating morbid obesity were included in the systematic review, including 11 on SLSG, 35 on CLSG, and 15 studies comparing SLSG and CLSG. A systematic review showed that the trocar number varied in different CLSG studies, mainly using four or five trocars. The trocars were mainly placed in position, presenting an inverted trapezoid pattern and a left-predominant pattern. Meta-analysis showed that the operative time in the SLSG was significantly higher than that in the CLSG, and the pain Visual Analog Scale rating on postoperative day 1 in the CLSG was significantly higher than in the SLSG. There were no statistical significances in the other complications or surgical efficiency. Conclusions: In the CLSG, the majority of the trocars were arranged in an inverted trapezoid pattern and were of the left-predominant type. Although SLSG is a feasible technique in selected patients, there is insufficient evidence to recommend its widespread use compared with CLSG. High-quality randomized controlled trials with large study populations and long follow-up periods will be required in the future.

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Section: Discussionmentioning

confidence: 99%

Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis

Jiang

Zhang

Feng

et al. 2023

International Journal of Surgery

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“…The majority (87%) described an observational, retrospective cohort study design (Tables 1-2). Most studies assessed weight outcomes to evaluate weight management programs (41%) (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25); the remaining studies evaluated postbariatric surgery weight changes (25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Sample sizes ranged from 40 (29) to 4,990,424 (36), with most studies (62%) including more than 1,000 patients.…”

Section: Literature Review Samplementioning

confidence: 99%

“…Two additional studies (5%) in this group reported using a Veterans Integrated Services Network database with unclear linkage to the national CDW (22,46). Other studies (44%) described using a facility EHR or related systems (Veterans Health Information Systems and Technology Architecture or Computerized Patient Record System) (11,(13)(14)(15)(24)(25)(26)(28)(29)(30)(31)(32)(33)(34)(35)47,48). The remaining studies were not specific about source or how data were extracted, listing MOVE!…”

Section: Data Sourcesmentioning

confidence: 99%

“…Studies used BMI (49%) or weight in pounds (41%) or kilograms (13%). Parameterization of weight outcomes included assessing change in weight from baseline to a follow-up time point (62%) (11,(16)(17)(18)(20)(21)(22)(23)(24)(25)(26)(28)(29)(30)(31)(32)(33)(34)(35)37,(40)(41)45,46) or weight trajectory over time (23%) (11)(12)27,31,38,(42)(43)47,48) as continuous variables. Several studies (46%) created a binary indicator to classify participants meeting a specific weight threshold (e.g., at least 5% weight loss) and then calculated the proportion of participants meeting this threshold (10,(12)(13)(14)(15)(17)(18)(20)(21)(22)(23)27,31,36,…”

Section: Measure Constructionmentioning

confidence: 99%

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Construction and Use of Body Weight Measures from Administrative Data in a Large National Health System: A Systematic Review

Annis

Freitag

Evans

et al. 2020

Obesity

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Administrative data are increasingly used in research and evaluation yet lack standardized guidelines for constructing measures using these data. Body weight measures from administrative data serve critical functions of monitoring patient health, evaluating interventions, and informing research. This study aimed to describe the algorithms used by researchers to construct and use weight measures. Methods: A structured, systematic literature review of studies that constructed body weight measures from the Veterans Health Administration was conducted. Key information regarding time frames and time windows of data collection, measure calculations, data cleaning, treatment of missing and outlier weight values, and validation processes was collected. Results: We identified 39 studies out of 492 nonduplicated records for inclusion. Studies parameterized weight outcomes as change in weight from baseline to follow-up (62%), weight trajectory over time (21%), proportion of participants meeting weight threshold (46%), or multiple methods (28%). Most (90%) reported total time in follow-up and number of time points. Fewer reported time windows (54%), outlier values (51%), missing values (34%), or validation strategies (15%). Conclusions: A high variability in the operationalization of weight measures was found. Improving methods to construct clinical measures will support transparency and replicability in approaches, guide interpretation of findings, and facilitate comparisons across studies.

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“…Характерною ознакою хворих, включених у дослідження, була наявність декількох супутніх захворювань з переважанням патології серцево-судинної системи, яку виявлено у 135 (65,8%) хворих, порушення ліпідного та вуглеводного обміну -у 161 (78,5%) та 135 (65,8%) пацієнтів відповідно, системи травлення -у 130 (63,4%), органів дихання у 63 (30,7%) хворих без статистично значущої різниці за частотою у групах дослідження, що відповідає даним, отриманим у ході досліджень інших авторів [9]. Метаболічний синдром було діагностовано у 135 (65,8%) хворих, включених в дослідження: у 70 (66,6%) хворих основної групи та у 65 (65%) пацієнтів групи порівняння (χ 2 =0,06, p=0,8).…”

Section: результати обговоренняunclassified

Dynamics of quality of life in patients with morbid obesity after biliopancreatic diversion and sleeve gastrectomy

Перехрестенко¹

2018

Rep. of Vinnytsia Nation. Med. Univ.

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The rapid progress of obesity surgery dictates the necessity to study the quality of life of patients after bariatric procedures. The aim of the study is to assess the dynamics of quality of life of patients with morbid obesity after biliopancreatic diversion in the modification of Hess-Marceau and the sleeve gastrectomy in order to improve the results of surgical treatment of the specified category of patients. The results of surgical treatment of 205 patients with morbid obesity who performed sleeve gastrectomy (main group — 105 patients) or biliopancreatic diversion by Hess-Marceau (comparison group — 100 patients) were analyzed. The study of the dynamics of quality of life of patients was performed in according the Moorehead-Ardelt II method. Statistical data processing was performed using the methods of variational and descriptive statistic using Statistica 6.0 statistical analysis package. Installed that biliopancreatic diversion by Hess-Marceau and sleeve gastrectomy allowed to significantly improve the quality of life of patients with an increase of the quality of life index with -1.5±0.7 in the comparison group and -1.6±0,6 in the main group up to 1.8±0.3 and 2.0±0.4 respectively (p<0.05 compared to pre-operative data) 60 months after surgery. A more pronounced positive dynamics of quality of life in patients of the main group in the time interval of 12–24 months after the operation was achieved due to the absence of severe late metabolic complications and undesirable side effects of biliopancreatic diversion and laparoscopic access for sleeve gastrectomy in 54.3% of patients. Thus, the quality of life of patients with morbid obesity before performing bariatric surgery is critically low and significantly improved after biliopancreatic diversion by Hess-Marceau as well as sleeve gastrectomy. The impact of bariatric surgery on the duration and quality of life of patients requires further multicenter randomized trials.

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Laparoscopic Sleeve Gastrectomy for Morbid Obesity at a Veterans Affairs Medical Center

Abstract: LSG is a safe and effective tool for morbid obesity with clinical and serological improvements for individuals who are unable to lose weight with medical management alone.

Cited by 6 publications

References 30 publications

Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis

Trocar number and placement for laparoscopic sleeve gastrectomy and comparison of single-incision and conventional laparoscopic sleeve gastrectomy: a systematic review and meta-analysis

Construction and Use of Body Weight Measures from Administrative Data in a Large National Health System: A Systematic Review

Dynamics of quality of life in patients with morbid obesity after biliopancreatic diversion and sleeve gastrectomy

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