Bariatric surgery improves urinary incontinence in morbidly obese individuals.

Background: Urinary incontinence is common in obese individuals. We report on the prevalence of urinary incontinence in patients undergoing bariatric surgery and the effect of surgically induced weight loss on urinary incontinence.

Methods: The prospectively collected data from 201 consecutive candidates for bariatric surgery were evaluated.

Morbidity of anastomotic leaks in patients undergoing Roux-en-Y gastric bypass.

Objective: To document the effect of anastomotic leaks on morbidity and mortality after Roux-en-Y gastric bypass (RYGB) for obesity.

Design: Prospectively collected data on 840 consecutive patients who underwent RYGB between 1998 and 2005. Multivariate logistic regression analysis was used to determine the effect of anastomotic leaks on postoperative morbidity independent of sex, age, preoperative body mass index, access (open vs laparoscopic), calendar year of RYGB, and comorbidities.

Objective evidence that bariatric surgery improves obesity-related obstructive sleep apnea.

Background: Obstructive sleep apnea (OSA) is associated with obesity. Our aim in this study is to report objective improvement of obesity-related OSA and sleep quality after bariatric surgery.

Methods: Prospective bariatric patients were referred for polysomnography if they scored >or=6 on the Epworth Sleepiness Scale.

Errant and unrecognized antiperistaltic Roux limb construction during Roux-en-Y gastric bypass for clinically significant obesity.

Background: Proper isoperistaltic orientation of the Roux limb is important. We report on 5 patients with errant anatomic construction of the Roux limb during Roux-en-Y gastric bypass for clinically significant obesity.

Methods: We performed a retrospective review of the medical records of these 5 patients.

Outcomes of bariatric surgery in patients > or =65 years.

Background: Although the Medicare Coverage Advisory Committee found that significant evidence supports the safety and effectiveness of bariatric surgery, few data are available on the outcomes of bariatric procedures in patients > or =65 years. The aim of this study was to report on contemporary outcomes of Roux-en-Y gastric bypass (RYGB) in patients > or =65 years.

Methods: We reviewed prospectively collected data from all patients > or =65 years who underwent RYGB at two Florida university-based programs from 1999 to 2005.

Spectrum and treatment of small bowel obstruction after Roux-en-Y gastric bypass.

Background: Small bowel obstruction (SBO) is a well-recognized complication of bariatric surgery. Many factors that play a role in the etiology of SBO affect the presentation, timing, and treatment after Roux-en-Y gastric bypass (RYGB). We reviewed our experience with SBO after open and laparoscopic RYGB.

Predictive factors of thromboembolic events in patients undergoing Roux-en-Y gastric bypass.

Background: Obesity is a major risk factor for postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE). Identifying those patients at the greatest risk for DVT/PE is essential to prevent thromboembolic events among patients undergoing Roux-en-Y gastric bypass (RYGB) for clinically significant obesity. This aim of the study is to identify factors associated with an increased likelihood of developing DVT/PE after RYGB.

Is Roux-en-Y gastric bypass safe after previous antireflux surgery? Technical feasibility and postoperative symptom assessment.

Background: Clinically significant morbid obesity is associated with an increased risk of gastroesophageal reflux disease. Vertical Roux-en-Y gastric bypass (RYGBP) is known to eliminate acid (and bile) in the pouch of cardia, which would provide control of reflux symptoms. The aim of our study was to assess the technical considerations, morbidity, and safety of RYGBP after previous antireflux surgery and evaluate postoperative reflux symptoms.

Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity.

Symptoms of gastroesophageal reflux disease (GERD) are frequent in patients with clinically significant obesity and are reported to improve after Roux-en-Y gastric bypass (RYGB). The purpose of this study is to determine timing and duration of improvement of GERD symptoms in patients undergoing RYGB. Prospectively collected data from patients who underwent RYGB from January 1998 to August 2004 were analyzed.

Prevention and management of access port site hernia associated with the laparoscopic adjustable gastric band.

Access port site hernia is a rare complication associated with the laparoscopic adjustable gastric band (LAGB). Specifically, this unique problem occurs when a fascial defect allows herniation adjacent to the Silastic tubing connects the LAGB to the access port. A 48-year-old woman who had previously undergone placement of LAGB presented with a bulge lateral to the access port; physical examination revealed a hernia near the access port.

Anastomotic leaks after laparoscopic gastric bypass.

The gastrojejunostomy may be the most technically challenging step when performing laparoscopic Roux-en-Y gastric bypass. Patients who develop anastomotic leaks have increased morbidity and mortality rates. Difficulty in diagnosis is related to nonspecific systemic symptoms and limitations in most radiological studies.