Primary laparoscopic gastric bypass can be performed safely in patients with BMI >or= 60.

Background: Several studies suggest patients with a body mass index (BMI; calculated as kg/m(2)) >or= 60 have a greater operative risk and so advocate a staged approach to bariatric procedures. This requires two separate operations and all associated risks. At our institution, we do not perform staged bariatric operations for these patients; we execute a single-stage laparoscopic Roux-en-Y gastric bypass (LGBP).

Bariatric surgery: current concepts and future directions.

The increasing use of bariatric procedures in the treatment of morbidly obese patients means that aesthetic plastic surgeons can expect to care for more and more patients who have undergone bariatric surgery. It is important for aesthetic surgeons to understand the procedures, outcomes, and possible complications to recognize the signs and symptoms of any potential problems. Candidates for bariatric surgery must have a body mass index (BMI) of at least 40 kg/m(2) or a BMI of 35 kg/m(2) with at least one comorbidity, plus demonstrated failure of nonsurgical means of weight control to control weight and no significant psychiatric disorders.

Gene expression changes evoked in a venous segment exposed to arterial flow.

Objective: This study was conducted to characterize the coordinated molecular changes evoked in the structure and composition of the wall of a venous segment when exposed to fistula flow.

Methods: An arteriovenous shunt was created in adult C57BL/6J mice. Remodeled veins and contralateral control jugular veins were isolated 7 days after surgery.