Roux-en-Y Gastric Bypass with Manual Intracorporeal Anastomoses in 3D Laparoscopy: Operative Technique.

Bariatric surgery is the only treatment for severe obesity recognized as truly effective, and Roux-en-Y gastric bypass is one of the most frequent procedures. The aim of this study is to present a 3D laparoscopic bypass technique with intracorporal anastomosis, performed completely by hand. After positioning the patient and creating the 20 mL gastric pouch, the gastrojejunal anastomosis is performed with two continuous sutures of resorbable V-Lock 3.

Long-Term Weight Loss, Metabolic Outcomes, and Quality of Life at 10 Years After Roux-en-Y Gastric Bypass Are Independent of Patients' Age at Baseline.

Background: Conflicting data have been published for bariatric surgery in older patients, with no long-term large-scale studies available. Our aim was to provide long-term (> 10 years) results on weight loss, metabolic outcomes, and quality of life in a large homogenous series of Roux-en-Y gastric bypass (RYGB) patients, according to age at baseline.

Patients And Methods: All consecutive patients who underwent primary RYGB between 1999 and 2007, and therefore eligible for 10-year follow-up, were retrospectively analyzed.

Changes in gene expression profile in human subcutaneous adipose tissue during significant weight loss.

Objective: To analyze the expression of peroxisome proliferator-activated receptor-γ1 and 2 (PPARγ1 and 2), 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1), and leptin in adipose tissue (AT) of obese women during weight loss following Roux-en-Y gastric bypass (RYGB) and to compare these levels with those obtained in AT of nonobese subjects.

Methods: Gene expression was determined by real-time RT-PCR prior to surgery and at 3, 6, and 12 months after RYGB.

Results: All obese patients lost weight, reaching a mean BMI of 29.

Mechanotransduction, PROX1, and FOXC2 cooperate to control connexin37 and calcineurin during lymphatic-valve formation.

Lymphatic valves are essential for efficient lymphatic transport, but the mechanisms of early lymphatic-valve morphogenesis and the role of biomechanical forces are not well understood. We found that the transcription factors PROX1 and FOXC2, highly expressed from the onset of valve formation, mediate segregation of lymphatic-valve-forming cells and cell mechanosensory responses to shear stress in vitro. Mechanistically, PROX1, FOXC2, and flow coordinately control expression of the gap junction protein connexin37 and activation of calcineurin/NFAT signaling.