LAPAROSCOPIC AND LAPAROTOMY BARIATRIC SURGERY IN A PUBLIC HOSPITAL IN BRAZIL: ARE THERE DIFFERENCES IN COSTS AND COMPLICATIONS?

Background: Despite its increasing popularity, laparoscopy is not the option for bariatric surgeries performed in the Brazilian public health system.

Aims: To compare laparotomy and laparoscopic access in bariatric surgery, considering aspects such as morbidity, mortality, costs, and length of stay.

Methods: The study included 80 patients who were randomly assigned to perform a Roux-en-Y gastric bypass.

Predictive Factors of Gastroesophageal Reflux Disease Symptoms Following Open Sleeve Gastrectomy in Brazil Using Clinical Questionnaire.

Purpose: To evaluate predictors of symptoms of gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) based on a clinical questionnaire.

Materials And Methods: This is a cross-sectional study. We included all patients who underwent open SG between May 2013 and March 2017 in a single institution.

Factibility of open vertical gastrectomy in Brazil´s Public Health System.

Objective: to analyse clinical and epidemiological characteristics, postoperative complications, and weight loss in patients undergoing conventional vertical gastrectomy in a hospital under Brazil's Public Health System (SUS).

Methods: cross-sectional longitudinal retrospective study based on data collection from medical records for variable analysis in patients undergoing open vertical gastrectomy in SUS, from July 2013 to January 2017.

Results: we analysed 296 patients operated on during the study period, of which 54% were male.

FOOD INTAKE EVALUATION DURING THE FIRST YEAR OF POSTOPERATIVE OF PATIENTS WITH TYPE 2 DIABETES MELLITUS OR GLYCEMIC ALTERATION SUBMITTED TO ROUX-EN-Y GASTRIC BYPASS.

Background: : Obesity is one of the main causes of glycemic change. Failure of clinical obesity treatment may lead to an increase in bariatric surgery. Dietary guidance, in conjunction with disabsorptive and hormonal factors resulting from the anatomical and physiological changes provoked by the surgery, is associated with changes in food intake.

Predictors of Success in Bariatric Surgery: the Role of BMI and Pre-operative Comorbidities.

Background: This is a retrospective review of 204 patients who underwent bariatric surgery. The impact of weight regain (WR), pre-operative comorbidities and BMI values on the recurrence of comorbidities was evaluated, and an equation was elaborated to estimate BMI at 5 years of bariatric surgery.

Methods: Pre-operative data, after 1 year and after 5 years, was collected from the medical records.

PROPOSAL OF A REVISIONAL SURGERY TO TREAT SEVERE NUTRITIONAL DEFICIENCY POST-GASTRIC BYPASS.

Background: The gastric bypass has nutritional and electrolyte disturbances rate of approximately 17%. The most common deficits are protein malnutrition, ferric and zinc, in addition to the vitamin. Although rare, some malnutrition stages reach such severity that ends up being necessary hospitalization and sometimes revisional or reversal surgical procedures.

COMPLICATIONS RELATED TO GASTRIC BYPASS PERFORMED WITH DIFFERENT GASTROJEJUNAL DIAMETERS.

Background: Among the options for surgical treatment of obesity, the most widely used has been the Roux-en-Y gastric bypass. The gastrojejunal anastomosis can be accomplished in two ways: handsewn or using circular and linear stapled. The complications can be divided in early and late.

PROPOSAL OF A REVISIONAL SURGERY TO TREAT NON-INSULINOMA HYPERINSULINEMIC HYPOGLICEMIA POSTGASTRIC BYPASS.

Background: Hyperinsulinemic hypoglicemia with severe neuroglycopenic symptoms has been identified as a late and rare complication in patients submitted to Roux-en-Y gastric bypass. However, the potential gravity of its manifestations requires effective treatment of this condition. The absence of treatment makes it necessary to develop more effective clinical or surgical methods.

EXTERNAL VALIDATION OF THE DIAREM SCORE AS REMISSION PREDICTOR OF DIABETES MELLITUS TYPE 2 IN OBESE PATIENTS UNDERGOING ROUX-EN-Y GASTRIC BYPASS.

Background: DiaRem score consists in preoperative model for predicting remission of type 2 diabetes mellitus in obese patients who underwent gastric bypass.

Aim: To evaluate the applicability of DiaRem comparing the scores obtained preoperatively with remission of T2DM after surgery.

Method: Preoperative parameters such as age, use of insulin, oral hypoglycemic agents and glycated hemoglobin, were retrospectively evaluated in diabetic patients undergoing gastric bypass during the period between July 2012 to July 2013.

Food quality in the late postoperative period of bariatric surgery: an evaluation using the bariatric food pyramid.

Bariatric surgery is an effective intervention in the treatment of obesity, but lifestyle and diet should be monitored after this procedure to ensure success. The Bariatric Food Pyramid was created basing on long-term nutritional care that proposes a standard of healthy living and eating habits considering gastric capacity and specific nutritional needs. The purpose of the current study is to evaluate the life habits and diet quality of patients who have undergone bariatric surgery (who have been recovering for at least 6 months) based on the specific food pyramid.

[Nutritional consultations frequency after bariatric surgery].

Background: With the growth of surgical interventions to reduce obesity, there is a necessity of a periodic nutritional attendance at long term to ensure the nutritional status of the patients.

Aim: To assess the adherence to the periodic nutritional attendance of patients undergoing bariatric surgery.

Methods: Data were collected from registration forms of a nutrition service from patients who underwent bariatric surgery between 2001 and 2008.

Laparoendoscopic Pfannenstiel nephrectomy using conventional laparoscopic instruments--preliminary experience.

Purpose: To confirm the feasibility of the laparoendoscopic Pfannenstiel nephrectomy using conventional laparoscopic instruments.

Materials And Methods: Since March 2009, laparoscopic nephrectomy through a Pfannenstiel incision has been performed in selected patients in our service. The Veress needle was placed through the umbilicus which allowed carbon dioxide inflow.

Bilateral retroperitoneoscopic lumbar sympathectomy by unilateral access for plantar hyperhidrosis in women.

Objectives: Primary focal hyperhidrosis is a disorder of excessive, bilateral, and relatively symmetric sweating occurring in the axillae, palms, soles, or craniofacial region. Armpits are affected in 51% of patients, feet in 29%, palms in 25%, and the face in 20%. There is a wide range of nonsurgical and surgical treatments available for patients with focal hyperhidrosis.

Transvaginal endoscopic tubal sterilization.

Background: Tubal sterilization is one of the most widely used options for female contraception. It can be performed by laparotomy, minilaparotomy, colpotomy, laparoscopy, and hysteroscopy. In this paper, we report the use of the transvaginal endoscopic approach to perform tubal ligation.

A comparison of hand-assisted and pure laparoscopic techniques in live donor nephrectomy.

Purpose: To compare hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy techniques in live donor nephrectomy.

Methods: In this retrospective study, we included all patients submitted to hand-assisted laparoscopic donor nephrectomy and pure laparoscopic live donor nephrectomy between May 2002 and December 2007. The operative data and post-operative courses were reviewed.

Hybrid transvaginal nephrectomy.

This case study reports one case of transvaginal natural orifice transluminal endoscopic surgery (NOTES) in a 23-yr-old woman with right flank pain and recurrent urinary tract infection due to a nonfunctional right kidney. She underwent nephrectomy by transvaginal NOTES using the endoscope by vaginal access and two additional 5-mm trocars in the abdomen. Total procedure time was 170 min and estimated blood loss was 350 cc.

Laparoscopic running urethrovesical anastomosis with posterior fixation.

Introduction: Laparoscopic radical prostatectomy is a minimally invasive approach for the treatment of localized prostate cancer. The most technically demanding and time-consuming part of this procedure is the urethrovesical anastomosis. Here we describe our technique for the urethrovesical anastomosis with a posterior fixation, using a running suture with two monofilament absorbable sutures.

Laparoscopic live donor nephrectomy in patients surgically treated for morbid obesity.

In the past, morbid obesity was considered a relative contraindication to renal donation; however, more recent publications have shown that laparoscopic renal surgery is safe and effective for obese donor nephrectomy. We report the performance of a bariatric surgery before the kidney donation in 2 patients in order to improve their medical condition and to reduce their surgical risk to the transplantation procedure. After bariatric surgery, both donors lost more than 30% of their initial corporal weight and their donation procedure was successfully performed, with uneventful postoperative courses.

Hand-assisted right laparoscopic live donor nephrectomy.

Purpose: Laparoscopic live donor nephrectomy has acquired an important role in the era of minimally invasive surgery. Laparoscopic harvesting of the right kidney is technically more challenging than that of the left kidney because of the short right renal vein and the need to retract the liver away from the right kidney. The aim of this article is to report our experience with right laparoscopic live donor nephrectomies.

Laparocopic ureteral reimplantation in ureteral stenosis after gynecologic laparoscopic surgery.

Pelvic surgery is the most common cause of iatrogenic ureteral injury, and traditionally repair of such injuries requires laparotomy. We report the case of a 48-year-old woman with an iatrogenic ureteral injury after laparoscopic ophorectomy which was laparoscopically reimplanted using the Lich-Gregoire technique. Total operating time was 150 minutes and estimated blood loss was 100 mL.

Maximizing the right renal vein length in laparoscopic live donor nephrectomy.

Laparoscopic donor nephrectomy has become the standard of care at increasing numbers of renal transplant programs worldwide. The majority of laparoscopic living donor kidneys are procured from the left side because of the longer renal vein and improved transplantation. The aim of this article is to report a technique to maximize the right renal vein length by performing a hand-assisted cavotomy.

[Effects of splenectomy on peritonitis produced by a colonic injury: study in rats].

Background: Study the effects of splenectomy on the intra-abdominal infection by bowel flora, consequent to a colonic injury in Wistar rats.

Methods: We used 64 animals, 20 for Group A1 (normal with colon lesion left open), 22 for Group A2 (normal with colon lesion sutured) and 22 for Group B (spleen removed). The animals were submitted to a laparatomy through a midline abdominal incision and peritonitis was induced by a colonic lesion in the colon previously distended with 2 ml of saline introduced in the rectum.