Effect of preoperative knowledge on weight loss after laparoscopic gastric bypass.

Introduction: Gastric bypass surgery has been demonstrated to be an effective treatment for morbid obesity. Unfortunately, not all patients have the same weight loss after surgery. It may be that the more informed patients will have more weight loss than less informed patients.

Laparoscopic repair of a staple-line disruption after an open uncut Roux-en-Y gastric bypass.

The technique of gastric bypass has undergone an evolution over the last 20 years, although it is often individualized based on surgeon preference. Whereas many surgeons divide and separate the gastric pouch from the distal bypassed stomach, some surgeons choose to staple, but not cut and separate the pouch. Staple-line failure resulting in a gastrogastric fistula and weight regain is a worrisome complication.

Results of teenaged bariatric patients performed in an adult program.

Background: Morbid obesity is a growing epidemic among adolescents. Bariatric surgery has proven to be the only long-term effective method in treating morbidly obese adults for over a decade. The laparoscopic approach has become a popular option.

Are African-Americans as successful as Caucasians after laparoscopic gastric bypass?

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to provide weight loss comparable to open gastric bypass. It has been suggested that African-Americans (AA) are not as successful as Caucasians (CA) after bariatric surgery. Our hypothesis was that AAs are just as successful as CA after LRYGBP in terms of weight loss and comorbidity improvement.

Non-closure of defects during laparoscopic Roux-en-Y gastric bypass.

Background: The concern about internal hernias has prompted recommendations for routine closure of defects during laparoscopic Roux-en-Y gastric bypass (LRYGBP). Our belief is that not all techniques require closure of defects. We hypothesize that non-closure of defects with our particular technique would not cause a significant clinically evident internal hernia rate.

Laparoscopic re-operations for band removal after open banded gastric bypass.

Background: Roux-en-Y gastric bypass (RYGBP) has been demonstrated to be an effective treatment for weight loss in the morbidly obese. Numerous variations of the RYGBP have been performed, including placing a ring proximal to the gastric outlet. This ring in RYGBP is intended to decrease pouch dilation and limit weight regain.

Laparoscopic bariatric patients' will to help: the foundation of research.

Background: Bariatric surgery is a fast growing field. Clinical research is essential to its safe delivery. Bariatric patient enthusiasm for research participation has never been objectively measured.

What happens to patients who do not follow-up after bariatric surgery?

Loss of follow-up is a concern when tracking long-term clinical outcomes after bariatric surgery. The results of patients who are "lost to follow-up" are not known. After bariatric surgery, the lack of follow-up may result in less weight loss for patients.

Laparoscopic revision of the gastrojejunostomy for recurrent bleeding ulcers after past open revision gastric bypass.

Late complications of open gastric bypass can include malnutrition, weight gain, stomal stenosis, and recurrent bleeding ulcers. Herein, we describe the case of a woman who had recurrent bleeding ulcers, after an open revision of a stenotic gastric bypass. She now underwent an uneventful laparoscopic revision of her gastrojejunostomy and was discharged within 72 hours.

Metabolic syndrome: yet another co-morbidity gastric bypass helps cure.

Background: The metabolic syndrome is a group of risk factors predictive of cardiovascular diseases. The rising number of obese Americans has increased the prevalence of metabolic syndrome. This study investigated the hypothesis that the incidence of metabolic syndrome is decreased after laparoscopic gastric bypass surgery.

Band versus bypass: randomization and patients' choices and perceptions.

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are becoming increasingly popular; however, little is understood about patients' motivational factors and reasons for choosing a particular procedure. This investigation explored patient choices and perceptions concerning LRYGB and LAGB.

Methods: A survey was given to 120 consecutive patients who had undergone LRYGB or LAGB 3-24 months earlier.

Mallory-Weiss tear after laparoscopic Roux-en-Y gastric bypass.

In the United States, the most common surgical procedure for morbid obesity is the Roux-en-Y gastric bypass. Pulmonary embolism, leak, bowel obstruction, and gastrointestinal bleeding are among the potential early fatal complications. Early postoperative bleeding after laparoscopic gastric bypass, although uncommon, presents a dilemma because of the danger of perforation from postoperative endoscopy and the inability to access the gastric remnant easily.

Outcome of a clinical pathway for discharge within 48 hours after laparoscopic gastric bypass.

Background: The benefits of laparoscopic gastric bypass (LGB) include decreased pain, quicker recovery, and shorter hospital stay. Our hypothesis was that a clinical pathway for 48-hour discharge after LGB can be implemented safely.

Methods: Charts of patients undergoing LGB were retrospectively reviewed to assess our prospectively placed clinical pathway.

Preoperative carbohydrate "addiction" does not predict weight loss after laparoscopic gastric bypass.

Background: Weight loss after laparoscopic Roux-en-Y gastric bypass (LRYGBP) varies. Dietary habits that exist preoperatively may continue after surgery and affect weight loss. This study investigated the hypothesis that preoperative carbohydrate addiction would predict weight loss after laparoscopic gastric bypass.

Emerging endoluminal therapies for gastroesophageal reflux disease: adverse events.

Background: Endoluminal therapies are emerging as a new therapeutic option for the treatment of gastroesophageal reflux disease (GERD). Many of these endoluminal therapies are touted as short outpatient procedures with minimal complications. It is thought that these complications are uncommon and minor.

Vitamin and trace mineral levels after laparoscopic gastric bypass.

Background: Nutritional deficiencies are a concern after any bariatric surgery procedure. Restriction of oral intake and/or decreased absorption may cause vitamin abnormalities. Prevention of these vitamin deficiencies includes both supplementation and routine measuring of serum values.

Laparoscopic lumbar hernia repair.

Lumbar hernias are rare clinical entities that often pose a challenge for repair. Because of the surrounding anatomy, adequate surgical herniorraphy is often difficult. Minimally invasive surgery has become an option for these hernias.

Does laparoscopic gastric bypass result in a healthier body composition? An affirmative answer.

Background: Bariatric surgery results in sustained weight loss. While weight loss is the goal of bariatric surgery, fat loss and muscle conservation are germaine goals. This study investigated the hypothesis that body composition would significantly change after laparoscopic Roux-en-Y gastric bypass (LRYGBP).

Why would laparoscopic gastric bypass patients choose open instead?

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGBP) has been demonstrated to be comparable to open Roux-en-Y gastric bypass (ORYGBP) surgery in randomized studies. Although a steep learning curve exists, laparoscopic bariatric surgery offers advantages if performed by an experienced bariatric surgeon. Despite these facts, some patients still choose to undergo ORYGBP.

Laparoscopic Roux-en-Y gastric bypass with subtotal gastrectomy.

Laparoscopic gastric bypass is a common procedure for morbid obesity. After gastric bypass, the distal stomach is unavailable for surveillance. When a suspicious distal gastric lesion is present preoperatively, a distal subtotal gastrectomy may be needed.

One-stitch laparoscopic gastric bypass technique for adolescents.

Morbid obesity is increasingly recognized in children and adolescents. The National Institute of Health Consensus Conference has concluded that bariatric surgery is the only consistent effective method for achieving long-term weight loss. Advantages of the laparoscopic approach, which include decreased hospital stay and morbidity, have been demonstrated in randomized controlled studies.

Inpatient pain medication requirements after laparoscopic gastric bypass.

Introduction: One of the benefits of laparoscopic Roux-en-Y gastric bypass (RYGBP) includes decreased pain, possibly resulting in decreased narcotic use, quicker recovery of bowel function, and shorter hospital stay. We utilize a pain management strategy for our patients undergoing laparoscopic RYGBP. We investigated this strategy as well as narcotic use and incidence of ileus.

Laparoscopic removal of gastric band after open banded gastric bypass.

Open banded gastric bypass has been the choice of some bariatric surgeons. This procedure includes a band (of various materials) around the gastric pouch. While there are advantages to this band, erosion and/or displacement of the band may occur.