Effect of Limb Length on Weight Loss Outcomes Following Biliopancreatic Diversion with Duodenal Switch: A Multi-Centered Study.

Purpose: The effectiveness of biliopancreatic diversion with duodenal switch (BPD/DS) for weight loss is well established, yet there remains ongoing debate over optimal limb lengths to maximize weight loss without compromising safety. We aimed to evaluate the impact of BPD/DS limb lengths on weight loss outcomes and comorbidity resolution.

Material And Methods: A multicenter review of patients who underwent primary BPD/DS between 2008 and 2022.

Internal hernia in patients after duodenal switch: A multi-centred comparative analysis.

Biliopancreatic diversion with duodenal switch (BPD-DS) and single anastomosis duodeno-ileostomy with sleeve (SADI-S) are associated with superior and sustained weight loss outcomes. Despite their growing popularity, long-term safety profiles, particularly the risk of internal hernia (IH), remain underexplored. This study aimed to evaluate the incidence and characteristics of IH following BPD-DS and SADI-S procedures, comparing their clinical presentation, diagnostic methods, and outcomes.

Single anastomosis duodenal switch versus Roux-en-Y gastric bypass in patients with BMI ≥ 50 kg/m: a multi-centered comparative analysis.

Background: Roux-en-Y gastric bypass (RYGB) has consistently demonstrated excellent weight loss and comorbidity resolution. However, outcomes vary based on patient's BMI. Single anastomosis duodeno-ileostomy with sleeve (SADI-S) is a novel procedure with promising short-term results.

Reflux After Sleeve Gastrectomy: Safety and Effectiveness of Laparoscopic Ligamentum Teres Cardiopexy, a Single-Center Experience.

Background: Obesity is a well-known risk factor for gastroesophageal reflux disease (GERD). Even though symptoms may be mitigated or resolved with the weight loss caused by sleeve gastrectomy (SG), it may be associated with higher incidences of postoperative GERD. Ligamentum teres cardiopexy (LTC) is an alternative to Roux-en-Y gastric bypass, the gold standard treatment for GERD.

Management of Malnutrition and Hepatic Impairment After Duodenal Switch.

Background: Malnutrition and liver impairment after duodenal switch (DS) are possible and undesired complications, often conservatively treated. However, in specific cases, surgical revision may be necessary. This study aims to describe outcomes achieved by two bariatric surgery centers and address effectiveness and safety of revisional surgical procedures to resolve these complications.

Comparative multicenter analysis of sleeve gastrectomy, gastric bypass, and duodenal switch in patients with BMI ≥70kg/m: a 2-year follow-up.

Patients undergoing metabolic and bariatric surgery (MBS) with body mass index (BMI) ≥ 70 kg/m are considered a high-risk group. There is limited literature to guide surgeons on the perioperative safety as well as the different procedural outcomes of MBS in this cohort. Our aim is to compare the safety profiles, early- and medium-term outcomes of sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS) in patients with BMI ≥ 70 kg/m.

Marginal Ulcer and Dumping Syndrome in Patients after Duodenal Switch: A Multi-Centered Study.

Background: The current design of biliopancreatic diversion with duodenal switch (BPD/DS) and single anastomosis duodenal-ileal bypass with sleeve (SADI-S) emphasizes the importance of the pylorus' preservation to reduce the incidence of marginal ulcer (MU) and dumping. However, no institutional studies have yet reported data on their prevalence. We aimed to assess the incidence of MU and dumping after duodenal switch (DS) and identify the associative factors.

Implementing novel modalities into an institutional enhanced recovery after bariatric surgery (ERABS) protocol.

Introduction: Enhanced recovery after bariatric surgery pathways are associated with improved postoperative outcomes. This study aims to assess efficacy and safety of three novel protocol contributions (transversus abdominis plane blocks, ketamine and fosaprepitant), as well as their impact on length of stay (LOS) and on postoperative complications.

Methods: Effectiveness and safety were retrospectively investigated in patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) over a 6-year period in a single institution.

Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs.

Purpose: Postoperative nausea and vomiting (PONV) is one of the most common adverse effects of anesthesia and surgery, resulting in patient discomfort and dissatisfaction. Latest research has demonstrated the efficacy of NK-1 receptor antagonists in PONV management and its use in chemotherapy nausea prophylaxis. The authors of this article would like to provide evidence to support the use fosaprepitant, as monotherapy, in postoperative care, replacing a polypharmacological standard of care regimen.

Impact of Perioperative Ketamine on Postoperative Bariatric Surgery Opioid Use and Length of Stay.

Settings: Postoperative pain management is an ever-growing challenge with the rise of the opioid crisis. Ketamine is an NMDA channel blocker, considered an alternative to perioperative opioid use; small concentrations are safe. Objective: The primary objective of this study was to evaluate the impact of perioperative ketamine administration on postoperative opioid use and the length of hospital stay in bariatric patients.

Single- Versus Double-Anastomosis Duodenal Switch: Outcomes Stratified by Preoperative BMI.

Purpose: Describe and analyze the safety and weight loss performance of biliopancreatic diversion and duodenal switch (BPD-DS) and single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S), verifying any possible superiority according to preoperative BMI.

Methods: Retrospective review of patients who underwent primary SADI-S or BPD-DS in three bariatric centers. Study groups were further stratified according to preoperative BMI (subgroup 1: BMI < 50; subgroup 2: 50 ≤ BMI < 55; subgroup 3: BMI ≥ 55).

Duodenal Switch Conversion in Non-responders or Weight Recurrence Patients.

Introduction: Several modalities have been proposed to tackle insufficient weight loss and weight regain after bariatric surgery; we aimed to evaluate efficacy and safety of duodenal switch conversion as a salvage procedure.

Material And Methods: Data from patients who underwent duodenal switch conversions (n = 50) were retrospectively studied. Excess weight loss % and total body weight loss % were compared between primary procedure and duodenal switch conversion.

ANTI-REFLUX PROCEDURES AFTER ROUX-EN-Y GASTRIC BYPASS.

Background: Roux-en-Y gastric bypass (RYGB) has been the choice of bariatric procedure for patients with symptomatic reflux - and is known to be effective in reducing the need for anti-reflux medication postoperatively. However, a small number of RYGB patients can still develop severe reflux symptoms that require a surgical intervention.

Aim: To examine and describe the patient population that requires an anti-reflux procedure after RYGB evaluating demographics, characteristics, symptoms and diagnosis.

To oversew or not to oversew in robotic sleeve gastrectomy: a case against oversewing the staple line.

Background: The benefits of oversewing the staple lines during laparoscopic sleeve gastrectomy have been controversial. No study examined the benefit of oversewing the staple lines in robotic sleeve gastrectomy (RSG). This retrospective study aims to examine the difference in immediate postoperative complications, readmissions, reoperations, and emergency room visits between RSG patients with and without oversewn staple lines at a single, large-volume, bariatric center.

Cardiopexy at the Time of Sleeve Gastrectomy as a Preventive Measure for Reflux.

Background: One of the most significant concerns after laparoscopic sleeve gastrectomy (LSG) is the new-onset or worsening of gastroesophageal reflux disease (GERD). Some patients with LSG undergo a conversion to Roux-en-Y gastric bypass (RYGB) because of severe GERD. Cardiopexy at the time of LSG may help prevent GERD.

Feasibility and safety of robot-assisted bariatric conversions and revisions.

Background: Conversions and revisions after bariatric procedures are inevitable and associated with longer operative time and higher complication rates. Because robot-assisted procedures allow better dissection, robotic conversions and revisions may be more beneficial to the patients than laparoscopic ones.

Objectives: This study aimed to compare the feasibility and safety of robot-assisted conversions and revisions to laparoscopic procedures.

Short-term results of long biliopancreatic limb Roux-en-Y gastric bypass-is it superior?

Objectives: To compare the short-term safety and effectiveness of long biliopancreatic limb Roux-en-Y gastric bypass (RYGB) to that of regular RYGB.

Setting: Academic hospital, United States.

Methods: A retrospective chart review was performed on 89 consecutive patients who underwent RYGB between February 4, 2014 and March 12, 2015.

Conversions of Roux-en-Y gastric bypass to duodenal switch (SADI-S and BPD-DS) for weight regain.

Background: Duodenal switch is a choice of conversion when patients fail to lose or regain weight after Roux-en-Y gastric bypass (RYGB). This study aims to evaluate the effectiveness and safety of duodenal switch as a secondary operation for patients who presented with insufficient weight loss or weight regain after a RYGB.

Methods: A retrospective chart review was performed on 15 patients who underwent a conversion of RYGB to single anastomosis duodeno-ileal bypass with sleeve (SADI-S) or biliopancreatic diversion with duodenal switch (BPD-DS) due to weight regain between December 31, 2013 and October 31, 2018.

Safety and short-term effectiveness of endoscopic sleeve gastroplasty using overstitch: preliminary report from a multicenter study.

Background: Endoscopic sleeve gastroplasty (ESG) is an option for patients with Class I and II obesity or patients who refuse to undergo a laparoscopic bariatric surgery. The aims of this study are as follows: (1) to demonstrate a short-term outcome after primary ESG and (2) to compare the effectiveness of weight loss between Class I and Class II obesity patients.

Methods: Patients undergoing ESG at four bariatric centers in Brazil between April 1, 2017 and December 31, 2018 were prospectively enrolled in the study (BMI 30.

Pathologic findings of the removed stomach during sleeve gastrectomy.

Background: Laparoscopic sleeve gastrectomy (LSG) is the preferred surgical intervention to treat morbid obesity. Despite the rising popularity of LSG, little is known on the histopathologic findings of the resected partial stomach specimens. Our study aims to identify prevalent pathologic findings of the removed stomach and explore the association between patient characteristics and abnormal findings.

Preoperative Transversus Abdominis Plane (TAP) Block with Liposomal Bupivacaine for Bariatric Patients to Reduce the Use of Opioid Analgesics.

Introduction: Postoperative pain remains the most common challenge following inpatient and outpatient surgeries, and, therefore, opioid analgesics are widely used during the perioperative period. The aim of this study is to examine the efficiency of transversus abdominis plane (TAP) block using liposomal bupivacaine in reducing the use of opioid analgesics during the perioperative period of bariatric procedures.

Material And Methods: A retrospective chart review was performed on 191 patients who underwent a laparoscopic bariatric procedure between September 13, 2017, and February 26, 2018.

Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution.

Background: Biliopancreatic diversion with duodenal switch (DS) is known to be superior in weight loss to other bariatric procedures, but with the disadvantage of increased complication rates. Single-anastomosis duodenal-ileal bypass (SADI-S) is reported to have similar weight loss with lower complication rates compared with traditional DS.

Objectives: The aim of this study was to compare weight loss and complication rate between SADI-S and double-anastomosis DS at a single institution.

Conversions After Sleeve Gastrectomy for Weight Regain: to Single and Double Anastomosis Duodenal Switch and Gastric Bypass at a Single Institution.

Background: With the increase in popularity of laparoscopic sleeve gastrectomy (LSG), the number of patients experiencing weight regain has increased as well. This study aims to demonstrate the outcomes of LSG conversions to Roux-en-Y gastric bypass (RYGB), double anastomosis duodenal switch (DS), and single anastomosis duodeno-ileal sleeve (SADI-S) due to weight regain.

Methods: A retrospective chart review was performed on 21 patients who underwent a conversion of LSG due to weight regain between March 1, 2013, and April 30, 2017.

Management of Bariatric Complications Using Endoscopic Stents: a Multi-Center Study.

Background: Complications after bariatric procedures including leaks and strictures can be difficult to treat. Endoscopic treatment may be preferable due to its less invasiveness. The aim of this study is to describe usage of stents in treating complications after bariatric procedures, along with its indications, methods, and outcome.

Efficacy of Utilizing Argon Plasma Coagulation for Weight Regain in Roux-en-Y Gastric Bypass Patients: a Multi-center Study.

Background: Endoscopic approaches exist for targeting weight regain after Roux-en-Y gastric bypass (RYGB), including endoscopic suturing, clipping, and sclerotherapy. Argon plasma coagulation (APC) is a noncontact electrocoagulation method, and when used in RYGB patients, it has shown reduction in the diameter of the gastrojejunal anastomosis.

Objectives: To study the effectiveness of APC for weight regain in terms of weight loss for RYGB patients, from eight bariatric centers.