Three-Port Laparoscopic Sleeve Gastrectomy: A Novel Technical Modification.

Laparoscopic sleeve gastrectomy has rapidly been adopted as a primary surgical procedure in bariatric patients. The technique of multiport sleeve gastrectomy is described using 4 to 6 ports and an additional port for a liver retractor. A technique of single-port sleeve gastrectomy has been described, the principal advantages of which appear to reduced postoperative pain and an improved cosmetic outcome.

The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity.

Objective: To evaluate the comparative effectiveness of sleeve gastrectomy (SG), laparoscopic gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB) procedures.

Background: Citing limitations of published studies, payers have been reluctant to provide routine coverage for SG for the treatment of morbid obesity.

Methods: Using data from an externally audited, statewide clinical registry, we matched 2949 SG patients with equal numbers of RYGB and LAGB patients on 23 baseline characteristics.

Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative.

Objectives: To develop a risk prediction model for serious complications after bariatric surgery.

Background: Despite evidence for improved safety with bariatric surgery, serious complications remain a concern for patients, providers and payers. There is little population-level data on which risk factors can be used to identify patients at high risk for major morbidity.

Open versus laparoscopic Roux-en-Y gastric bypass: a comparative study of over 25,000 open cases and the major laparoscopic bariatric reported series.

Background: Laparoscopic bariatric surgery has experienced a rapid expansion of interest over the past 5 years, with a 470% increase. This rapid expansion has markedly increased overall cost, reducing surgical access. Many surgeons believe that the traditional open approach is a cheaper, safer, equally effective alternative.

Percutaneous endoscopic gastrostomy in ICU patients with previous laparotomy.

To our knowledge, there is an absence of data evaluating the safety and efficacy of percutaneous endoscopic gastrostomy (PEG) placement in ICU patients with previous abdominal surgery. Our goals were to determine the complication rate of PEG in ICU patients who either had a recent or prior laparotomy compared to patients without any prior abdominal surgery. Prospective data was collected on 42 consecutive patients with prior abdominal surgery who underwent PEG placement in a university ICU setting during a 3-year period.

Nontherapeutic laparotomies revisited.

A wide variability exists in the reported incidents of complications following nontherapeutic laparotomy for trauma. We undertook this study to examine the decision-making leading to and complication rates related to the use of nontherapeutic laparotomy in an era of nonoperative management. We conducted a retrospective chart review of all nontherapeutic laparotomies as defined by the operating surgeon performed between May 1998 and May 2001.