Enhanced recovery after bariatric surgery (ERABS) in a high-volume bariatric center.

Background: The growing demand for bariatric surgery has been accompanied by an expensive technological evolution and the need to contain healthcare costs and to increase the quality of care. The enhanced recovery after surgery (ERAS) protocols applied to the bariatric setting can be the answer to all these different issues.

Objectives: Feasibility and safety of ERAS protocol in a single, high-volume bariatric center.

Laparoscopic sleeve gastrectomy in a patient with situs viscerum inversus totalis: is the life easy upside-down?

Introduction: Obesity is an epidemic on the rise [1]. The number of bariatric procedures has increased worldwide. Laparoscopic sleeve gastrectomy (LSG) is a valid therapeutic option, leading to a sustained weight loss with a low complication rate [2].

Long-term outcome with the prophylactic use of polypropylene mesh in morbidly obese patients undergoing biliopancreatic diversion.

The use of prosthetic material to prevent incisional hernia in clean-contaminated procedures as bariatric surgery remains controversial. We present our experience on 45 consecutive morbidly obese patients undergoing biliopancreatic diversion that was closed using a polypropylene mesh. Moreover, we reviewed the outcome of the 50 previous consecutive obese patients who underwent biliopancreatic diversion and conventional closure of the abdomen in order to compare the outcome between the two groups after a minimum follow-up of 2 years.

Incisional hernia prophylaxis in morbidly obese patients undergoing biliopancreatic diversion.

Background: The development of incisional hernia after open bariatric surgery is a major cause of morbidity and hospital readmission. The use of prosthetic material in clean-contaminated procedures remains controversial and correlated to high rate of local complications. A prospective observational clinical study on two different surgical techniques used to close the abdominal wall has been performed to better assess the safety (primary end point) and the efficacy (secondary end point) of polypropylene mesh placement to prevent incisional hernia in morbidly obese patients undergoing biliopancreatic diversion (BPD).

Perforation of an adjustable gastric banding connecting tube into distal transverse colon with intra-luminal migration.

Laparoscopic adjustable gastric banding (LAGB) is one of the most common bariatric procedures performed in Europe and Australia. Major post-operative complications are limited but once they occur, prompt diagnosis and treatment are mandatory. LAGB complications are related either to the port and the connecting tube, such as infection or tubing disconnection and migration, or to the band, such as slippage, pouch dilatation, or intra-gastric migration.