Gastric Emptying and Its Correlation With Weight Loss and Body Mass Index in Patients With an Intragastric Balloon: A Prospective Study With Six Years of Follow-Up.

Background Obesity is the most well-established and prolonged pandemic in modern society. Having a better understanding of the available tools is important to improve weight loss and make the strategies more productive. This study aims to evaluate the effect of intragastric balloon (IGB) on gastric emptying time, its relationship with weight loss after IGB removal, and weight maintenance after six years.

Antibiotics to Prevent Relapse of Adjustable Gastric Balloon Hyperinflation: Feasible for Balloon Maintenance?

The placement of an intragastric balloon (IGB) plays an increasingly important role in the treatment of obesity. The authors describe the cases of 2 female patients, 34 and 62 years old, who were submitted to the implantation of a Spatz3® IGB to treat obesity. Ten to fourteen weeks later, the patients presented complaints of epigastric pain, vomiting, and abdominal distension.

Vertical Endoscopic Gastroplasty in a Patient With Situs Inversus Totalis.

Bariatric surgery in patients with any deviation from normal anatomy is a challenge and requires considerable experience on the part of the surgeon. Situs inversus totalis (SIT) is a rare congenital abnormality (1:5,000-1:20,000 live births), and any surgical procedure on these patients can be somewhat challenging. A 44-year-old woman with morbid obesity, systemic arterial hypertension, and SIT underwent vertical endoscopic gastroplasty.

Endoscopic sleeve gastroplasty in the management of weight regain after sleeve gastrectomy.

Background: Sleeve gastrectomy is a well-standardized surgical treatment for obesity. However, rates of weight regain after sleeve gastrectomy in long-term follow-up are relatively high. This multicenter study is the first to evaluate the use of an endoscopic sleeve gastroplasty (ESG) technique for the management of this population.

The First Study Evaluating Effectiveness and Safety of the Endoscopic Sleeve Gastroplasty in HIV Patients.

The authors evaluated, retrospectively, the endoscopic sleeve gastroplasty impact in seven HIV patients, regarding effectiveness and safety outcomes. The mean baseline body mass index (BMI) was 33.76 kg/m.

Resuturing of Stomach in Endoscopic Sleeve Gastroplasty 8 Months After Original Procedure.

Endoluminal treatments such as endoscopic gastroplasty have been gaining ground in obesity treatment. A 52-year-old woman gained weight 5 months after endoscopic gastroplasty. Thus, it was decided to resuture the greater curvature of the stomach 8 months after the initial procedure by reducing the gastric pouch even further.

Endoscopic sleeve gastroplasty in the management of overweight and obesity: an international multicenter study.

Background And Aims: Obesity is a pandemic affecting approximately 700 million adults worldwide, with an additional 2 billion overweight. Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic bariatric therapy that involves remodeling of the greater curvature in an effort to reduce gastric capacity and delay gastric emptying. A variety of ESG suture patterns has been reported.

Increased Gastric Retention Capacity, Assessed by Scintigraphy, after APC Treatment of Dilated Gastrojejunal Anastomosis.

Background: Weight regain occurs in about 20% of patients after Roux-en-Y gastric bypass (RYGB). Studies have reported that in most cases this regain is associated with dilatation of the gastrojejunal anastomosis. To correct this dilatation, one of the methods used is the application of argon plasma coagulation (APC).

Exclusively endoscopic approach to treating gastric perforation caused by an intragastric balloon: case series and literature review.

Obesity is a serious disease, resulting in significant morbidity and mortality. Intragastric balloons (IGBs) have been in use since the 1980s. After the insertion of an IGB, complications such as migration of the device and even severe gastric perforation can occur, requiring laparoscopic surgery.

Intragastric Balloon Hyperinsufflation as a Cause of Acute Obstructive Abdomen.

Recently, the Food and Drug Administration approved the use of the Orbera balloon for obesity treatment. However, the Food and Drug Administration later issued a warning about the possibility of 2 complications not previously reported: acute pancreatitis and balloon hyperinsufflation. This case report is intended to alert all clinicians that, although rare, cases of hyperinsufflation should be considered in patients with an intragastric balloon (IGB) and acute abdomen.

EUS-Guided Intragastric Injection of Botulinum Toxin A in the Preoperative Treatment of Super-Obese Patients: a Randomized Clinical Trial.

Background: Obesity is a disease that is highly prevalent in Brazil, and the associated comorbidities represent a major global public health challenge. Botulinum toxin type A (BTX-A) is a potent neurotoxin and inhibitor of gastric smooth muscle activity. In theory, BTX-A administration should promote early satiety and weight loss because it delays gastric emptying by inhibiting acetylcholine-mediated peristalsis, which is primarily responsible for gastric motility.

FUNDOPLICATION CONVERSION IN ROUX-EN-Y GASTRIC BYPASS FOR CONTROL OF OBESITY AND GASTROESOPHAGEAL REFLUX: SYSTEMATIC REVIEW.

Introduction: Obesity is related with higher incidence of gastroesophageal reflux disease. Antireflux surgery has inadequate results when associated with obesity, due to migration and/or subsequent disruption of antireflux wrap. Gastric bypass, meanwhile, provides good control of gastroesophageal reflux.

Validation of a new method for the endoscopic measurement of post-bariatric gastric outlet using a standard guidewire: an observer agreement study.

Background And Aims: Between 10 and 20% of all patients undergoing bariatric surgery procedures regain weight secondary to a gastrojejunostomy enlargement. The aim of this study was to validate the interobserver agreement while measuring gastric outlet diameters using a new standard guidewire.

Methods: We selected thirty-five videos of consecutive endoscopic procedures on patients undergoing esophagogastroduodenoscopy after a Roux-en-Y gastric bypass procedure.

ENDOSCOPIC SLEEVE GASTROPLASTY - MINIMALLY INVASIVE THERAPY FOR PRIMARY OBESITY TREATMENT.

Background: Less invasive and complex procedures have been developed to treat obesity. The successful use of Endoscopic Sleeve Gastroplasty using OverStitch(r) (Apollo Endosurgery, Austin, Texas, USA) has been reported in the literature.

Aim: Present technical details of the procedure and its surgical/ endoscopic preliminary outcome.

Laparoscopic total gastrectomy as an alternative treatment to postsleeve chronic fistula.

Background: Sleeve gastrectomy (SG) has become a very common 1-stage procedure in bariatric surgery. Postsleeve chronic fistulas could be one of the possible complications and represent a true challenge for the surgeons. After the failure of more conservative treatments, including surgical and endoscopic approaches, laparoscopic total gastrectomy (LTG) could be an alternative treatment proposal.

Total clipless cholecystectomy by means of harmonic sealing.

Background: In traditional laparoscopic cholecistectomy, the cystic duct and artery are commonly closed by metallic clips just before their division. Although the placement of these clips for occluding cystic artery and duct can be considered safe, biliary leaks and bleeding may occur especially by its dislodgement.

Aim: To report a prospective case-series in total clipless cholecystectomy by means of harmonic shears for closure and division of the artery and cystic duct as well removal of the gallbladder from the liver.

Effects of Duodenal-Jejunal Bypass Liner (EndoBarrier®) on Gastric Emptying in Obese and Type 2 Diabetic Patients.

Introduction: The duodenal-jejunal bypass liner (DJBL) is a promising technique for treating obesity and type 2 diabetes mellitus (T2DM). However, despite promising results, its mechanism of action has not been elucidated. It is thought to promote changes in gastric emptying owing to the neuro-endocrine axis.

Simplified gastric bypass: 13 years of experience and 12,000 patients operated.

Background: Obesity is increasingly prevalent disease worldwide and bariatric surgery is the most effective treatment for the most severe cases. The Roux-en-Y gastric bypass is still the most used technique all over the world and the laparoscopic approach has been preferred by surgeons with different approaches, propositions and techniques in performing the procedure.

Aim: To report the surgical aspects of the systematization and results of the simplified laparoscopic gastric bypass (Brazilian technique).

Endoscopic dilation of gastrojejunal anastomosis after gastric bypass.

Introduction: Roux-en-Y gastric bypass may result in stenosis of the gastrojejunal anastomosis. There is currently no well-defined management protocol for this complication.

Aim: Through systematic review, to analyze the results of endoscopic dilation in patients with stenosis, including complication and success rates.

Improvement of insulin resistance and reduction of cardiovascular risk among obese patients with type 2 diabetes with the duodenojejunal bypass liner.

Background: This study aims to evaluate the effectiveness of the duodenojejunal bypass liner (DJBL) in the improvement of insulin resistance and reduction of cardiovascular risk among morbidly obese patients with type 2 diabetes mellitus, using the triglyceride/high-density lipoprotein (HDL) cholesterol ratio, percentage of weight loss, and glycemic control.

Methods: We used the TG/HDL ratio with a cutoff value of 3.5 to identify patients with insulin resistance.