Effects of laparoscopic Roux-en-Y gastric bypass on bone mineral density and markers of bone turnover.

Background: Despite multiple beneficial effects of weight loss after laparoscopic Roux-en-Y gastric bypass (LRYGB), the influence on bone mineral density (BMD) remains largely unknown. Our objective was to evaluate the changes in BMD and serum/urine bone markers after LRYGB.

Methods: Thirty-four women undergoing LRYGB were prospectively enrolled and underwent bone densitometry and serum/urine analysis preoperatively and 1 year postoperative.

Seconds from disaster: lessons learned from laparoscopic release of the median arcuate ligament.

Median arcuate ligament syndrome (MALS) is a rare entity that manifests as abdominal pain, nausea, vomiting, and diarrhea. The median arcuate ligament is a fibrous band that connects the crura of the diaphragm. In some people, the ligament is positioned in a way that compresses the celiac axis, which in a subset of individuals causes the symptoms associated with MALS.

Ascorbic acid deficiency in bariatric surgical population.

Background: To determine the prevalence of ascorbic acid deficiency in the surgical population, whether the body mass index (BMI) has an effect on ascorbic acid concentrations; and whether an association exists between ascorbic acid deficiency and adverse surgical outcomes.

Methods: Preoperative plasma ascorbic acid concentrations were prospectively assessed in 20-60-year-old patients undergoing elective abdominal surgery. Ascorbic acid deficiency was defined as any concentration < or =0.

Effect of preoperative weight loss on laparoscopic gastric bypass outcomes.

Background: Requiring patients to lose weight before weight reduction surgery is controversial. The goal of this study was to determine whether preoperative weight loss affects laparoscopic Roux-en-Y gastric bypass surgery outcomes.

Methods: The medical records of all laparoscopic Roux-en-Y gastric bypass patients from September 1, 2001 to March 31, 2005 were retrospectively reviewed in our prospective database.

Brachial plexus injury: long-term functional outcome is determined by associated scapulothoracic dissociation.

Background: Trauma to the brachial plexus may result in devastating neurologic dysfunction associated with musculoskeletal and vascular injuries.

Methods: Twenty-nine patients with unilateral brachial plexus injury caused by blunt trauma treated at a single institution were identified and divided into two subgroups: those with isolated brachial plexus injury (ISOL) (n = 18, 62%); and those with associated scapulothoracic dissociation (SD) (n = 11, 38%). Hospital and outpatient records for each patient were retrospectively reviewed, and long-term outcome was determined by use of an 18-question telephone survey.

Delayed neurologic deficit after infrarenal endovascular aortic aneurysm repair.

Spinal cord ischemia is a rare and devastating complication after elective abdominal aortic aneurysm repair. It has recently been reported to occur after endovascular aortic aneurysm repair. We report the first case of delayed neurologic deficit after endovascular aortic aneurysm repair using the Zenith (Cook) device.