Publications by authors named "Ken Loi"

Article Synopsis
  • * A study using a consensus method involved 78 bariatric surgeons globally, who agreed on 54 statements regarding when to use MBS for Class I and II obesity, determining a 70% agreement threshold.
  • * The experts concluded that MBS is cost-effective for Class II obesity and Class I obesity with inadequate weight loss from non-surgical methods, and identified specific surgical options including intra-gastric balloon, endoscopic sleeve gastroplasty, sleeve gastrectomy, Roux-en-Y gastric bypass, and one
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Introduction: Bariatric surgery has demonstrated long-term effectiveness in inducing weight loss and improving metabolic parameters for obesity. Single anastomosis duodeno-ileal (SADI) bypass and single anastomosis sleeve-ileal (SASI) bypass have both emerged as new promising bariatric procedures. In this paper, we review the existing literature and compare the outcomes of SADI and SASI bypass procedures in regard to weight loss, complication rate, and improvement of type II diabetes (T2DM).

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MAJOR UPDATES TO 1991 NATIONAL INSTITUTES OF HEALTH GUIDELINES FOR BARIATRIC SURGERY: Metabolic and bariatric surgery (MBS) is recommended for individuals with a body mass index (BMI) >35 kg/m, regardless of presence, absence, or severity of co-morbidities.MBS should be considered for individuals with metabolic disease and BMI of 30-34.9 kg/m.

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Purpose: One anastomosis/mini gastric bypass (OAGB/MGB) is up to date the third most performed obesity and metabolic procedure worldwide, which recently has been endorsed by ASMBS. The main criticisms are the risk of bile reflux, esophageal cancer, and malnutrition. Although IFSO has recognized this procedure, guidance is needed regarding selection criteria.

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Background: Mesh is frequently utilized intraoperatively for the repair of groin hernias. However, patients may request non-mesh hernia repairs owing to adverse events reported in other mesh procedures. To inform surgical safety, this study aimed to compare postoperative complications between mesh and non-mesh groin hernia repairs and identify other operative and patient-related risk factors associated with poor postoperative outcomes.

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Background: Long-term weight loss effect of bariatric surgeries for patients with Prader-Willi Syndrome (PWS) remains controversial since factors like postoperative home care intensity may impact the outcome. The aim of this study was to evaluate the role of home care intensity on long-term weight loss effect of bariatric surgery in patients with PWS.

Methods: This was a prospective observational study on patients with PWS undergoing bariatric surgery and patients were enrolled from July 2015 to December 2016.

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There are several bariatric procedures used for the effective management of obesity that employ restrictive or malabsorptive components to achieve effective weight loss and reduction in metabolic disease. The single anastomosis duodeno-ileal (SADI) bypass was first introduced as a simplification of the biliopancreatic diversion with a duodenal switch [1], often accompanied by sleeve gastrectomy (SADI-S) or as an alternative gastric sleeve revision procedure to Roux-en-Y gastric bypass [2]. SADI was developed to address the technical complexity associated with other bypass reconstructions by involving only one anastomosis while preserving pyloric function, minimising dumping symptoms.

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Obturator hernia is a rare and diagnostically challenging type of pelvic hernia with associated high morbidity and mortality. It is frequently seen in frail, elderly female multiparous patients with non-specific symptoms and signs that may be clouded by multiple gastrointestinal or musculoskeletal comorbidities. This report discusses the case of an 84-year-old woman with refractory groin pain and previous laparoscopic inguinal hernia repair that was misdiagnosed leading to a delayed diagnosis and mortality.

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Obesity has rapidly become a significant public health issue. As the prevalence of obesity continues to rise, so does its economic burden as a result of both direct and indirect costs. Likewise, since 2019, the coronavirus disease of 2019 (COVID-19) has become a global pandemic with rising infection rates carrying significant economic costs associated with treatment of the disease and the reduction in economic activity due to government regulations.

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Choledocholithiasis in post-surgical bariatric Roux-en-Y gastric bypass patients presents a significant challenge secondary to altered anatomy. We aim to review the existing management options including either endoscopic, surgical, percutaneous or hybrid means. Current literature suggests reasonably successful cannulation rates for single- or double-balloon ERCP ranging from 50 to 70% and 63-83%, respectively.

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Background: Laparoscopic sleeve gastrectomy (LSG) is a type of bariatric technique that has comparable outcomes to Roux-en-Y gastric bypass, the current gold standard. However, it can be associated with nutritional deficiencies postoperatively. The aim of this study was to evaluate micronutrient status post LSG.

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Background: Laparoscopic groin hernia repair is an increasingly common procedure with benefits of reduced post-operative pain and infection. Post-operative chronic pain remains an ongoing concern in about 10% of patients. Parietex ProGrip™, a polyester self-gripping mesh, has a theoretical benefit of avoiding tacks for mesh-fixation.

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Introduction: Retrieval bags are used in laparoscopic cholecystectomies to reduce the risk of bile and gallstone spillage during removal of the gallbladder. Retrieval bag rupture is rare, and its complications have never been previously documented.

Presentation Of Case: A 17-year-old female presented three months post-laparoscopic cholecystectomy with a tender periumbilical mass.

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Obesity is considered the most common nutritional disorder in Western countries and is related to multiple morbidity and mortality. There are different options for obesity treatment, including diet, behavioral therapy, medications, and surgery. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction.

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Background: Worldwide, the laparoscopic sleeve gastrectomy (LSG) is becoming the dominant bariatric procedure due to its reliable weight loss and low complication rate. Portomesenteric vein thrombosis (PVT) is an uncommon complication of LSG with an incidence of .3% to 1% and can lead to serious consequences, such as bowel ischemia and death.

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Background: Laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure has shown to be effective in achieving significant weight loss and resolving obesity-related co-morbidities. However, its nutrition consequences have not been extensively explored. This study aims to investigate weight loss and evolution of nutritional deficiencies in a group of patients 3 years post LSG.

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Introduction: Compared with open surgery, laparoscopic groin hernia repair has been shown to significantly reduce postoperative pain. However, chronic pain remains a problem with the laparoscopic approach, affecting approximately 10% of patients. The purpose of this study was to evaluate clinical outcomes following the use of Parietex ProGrip™ (Covidien, Dublin, Ireland) self-gripping mesh during laparoscopic totally extraperitoneal groin hernia repair.

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Background: Laparoscopic sleeve gastrectomy (SG) is gaining popularity as a revision option after failed laparoscopic adjustable gastric banding (LAGB). Data have shown that single stage revisions may be associated with a higher complication rate. A histologic basis for this observation has not been studied.

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Background: Retroperitoneal lymphoceles (RPLs) caused by injury to the lymphatics are commonly seen after pelvic lymphadenectomy, renal transplantation, and gynecologic tumor resection surgeries. Degenerative disc disease still remains the major cause of low-back pain. Anterior lumbar spinal procedures, such as anterior lumbar interbody fusion and anterior lumbar arthroplasty, have been increasingly performed for treatment of axial back pain.

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Background: In our centre laparoscopic Roux-en-Y gastric bypass (LRYGBP) is the most effective weight loss surgical procedure performed. However, LRYGBP may be associated with higher risk of peri- and postoperative complications in contrast to a purely restrictive procedure to justify this procedure on all comers. Laparoscopic sleeve gastrectomy (LSG) as a staged procedure may be an alternate risk reduction strategy.

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Background: Despite the favourable effects of adiponectin on the vasculature and insulin resistance (IR), levels are increased in patients with end-stage kidney disease (ESKD), in whom both IR and atherosclerosis are prevalent.

Methods: To investigate this paradox, we examined the distribution of adiponectin isoforms, the expression of adiponectin receptor (AdipoR) mRNA on peripheral blood mononuclear cells (PBMC) in 41 patients with ESKD on haemodialysis and 41 matched controls, and its function by adenosine monophosphate-activated protein kinase (AMPK) phosphorylation of AdipoR on PBMC. We also compared the expression of AdipoR on PBMC with that on muscle and subcutaneous and visceral fat in 10 patients undergoing elective cholecystectomy.

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Morbid obesity (defined as having a body mass index [BMI] > 40 kg/m(2), or BMI > 35 kg/m(2) with obesity-related comorbidities) is a medical disorder associated with increased morbidity and mortality. Management guidelines published by the National Health and Medical Research Council and by similar US and UK bodies have recommended surgery as the most effective treatment available for selected patients with morbid obesity. A recent meta-analysis of obesity surgery has documented its safety and effectiveness in resolving some of the major medical comorbidities that occur in obese patients.

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