Space surgery: a SAGES' white paper.

Background: Space travel is experiencing a renaissance with expanding commercial and international efforts. Space surgery will have growing relevance as mission frequency and distances increase beyond low Earth orbit.

Methods: This white paper from the SAGES Space Surgery Task Force raises awareness among the SAGES membership regarding the challenges and opportunities surrounding this emerging field that anticipates surgical care in the most extreme, austere environments.

Use of GLP-1 agonists in high risk patients prior to bariatric surgery: a cohort study.

Introduction: Body mass index (BMI) > 50 kg/m is associated with relatively increased morbidity and mortality with bariatric surgery (BS). There is reluctance to consider these patients operative candidates without preoperative weight loss. Glucagon-like peptide-1 (GLP-1) agonists have demonstrated effective weight loss in the post-BS setting.

National usage of bariatric surgery for class I obesity: an analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

Background: National and international consensus statements, as well as the National Institutes of Health (NIH), support the use of bariatric surgery for the treatment of class I obesity. Despite this, most payors within the United States limit reimbursement to the outdated 1991 NIH guidelines or a similar adaptation.

Objectives: This study aimed to determine the safety of bariatric surgery in patients with lower BMI compared with standard patients, as well as determine U.

Why the military committee is important to SAGES?

Background: SAGES established a military committee in 2009 and since that time. It may not be readily clear why a traditionally laparoscopic and endoscopic surgical society should have a military committee whose members' primary mission is combat surgery. Military surgeons have a second mission, though, which is to provide care for all its beneficiaries in all the surgical subspecialties.

Effect of obesity on outcomes after breast reconstruction surgery, an analysis of national surgical quality improvement program.

Background: Obesity is a risk factor for breast cancer and may affect the incidence, and outcomes of surgical treatment for breast cancer, including breast reconstruction.

Objective: This study aimed to evaluate outcomes of breast reconstruction in patients with obesity.

Methods: In a retrospective review of the NSQIP 2013-2018, adult patients who underwent breast reconstruction were included.

Postoperative sepsis after primary bariatric surgery: an analysis of MBSAQIP.

Background: Identifying patients at higher risk of postoperative sepsis (PS) may help to prevent this life-threatening complication.

Objectives: This study aimed to identify the rate and predictors of PS after primary bariatric surgery.

Setting: An analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) 2015-2017.

Time to weigh in on obesity and associated comorbidities in combat-wounded amputees.

Background: The Joint Trauma System database estimates that about 1,200 individuals have sustained a combat-related amputation during the Global War on Terror. Previous retrospective studies have demonstrated that combat-related amputees develop obesity and cardiovascular disease, but the incidence of obesity and associated comorbidities in this population is unknown. The objectives of this study are to determine the prevalence of obesity in the military amputee population and to compare this with the general population.

Is the minimally invasive trauma surgeon the next (r)evolution of trauma surgery? Indications and outcomes of diagnostic and therapeutic trauma laparoscopy in a level 1 trauma centre.

The aim of this study was to evaluate the trend in use, feasibility and safety of laparoscopy in a single level 1 European trauma centre. Laparoscopy in abdominal trauma is gaining acceptance as a diagnostic and a therapeutic tool as it reduces surgical invasiveness and may reduce post-operative morbidity. All trauma patients who underwent a laparoscopic procedure between January 2013 and December 2017 were retrospectively analysed.

Safe surgery in the elderly: A review of outcomes following robotic proctectomy from the Nationwide Inpatient Sample in a cross-sectional study.

Background: As our nation's population ages, operating on older and sicker patients occurs more frequently. Robotic operations have been thought to bridge the gap between a laparoscopic and an open approach, especially in more complex cases like proctectomy.

Methods: Our objective was to evaluate the use and outcomes of robotic proctectomy compared to open and laparoscopic approaches for rectal cancer in the elderly.

Open versus laparoscopic unilateral inguinal hernia repairs: defining the ideal BMI to reduce complications.

Objectives: Open inguinal hernia repair is felt to be a less expensive operation than a laparoscopic one. Performing open repair on patients with an obese body mass index (BMI) results in longer operative times, longer hospital stay, and complications that will potentially impose higher cost to the facility and patient. This study aims to define the ideal BMI at which a laparoscopic inguinal hernia repair will be advantageous over open inguinal hernia repair.

Symptomatic hibernoma: a rare soft tissue tumor.

Hibernomas are benign soft tissue tumors containing prominent brown adipocytes that resemble normal brown fat. Hibernomas have not been associated with malignant potential; however, they are similar in clinical presentation to malignant tumors like liposarcomas. This article describes the clinical, radiographic, and histologic features of a patient with a hibernoma arising from the left superior flank.

Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation.

Background: Laparoscopic distal pancreatectomy is associated with high morbidity and mortality. NOTES tumor enucleation may provide an alternative to laparoscopic distal pancreatectomy. The goal of this study was to determine the feasibility of NOTES tumor creation and enucleation as a multidisciplinary approach.