Bowel length: measurement, predictors, and impact on bariatric and metabolic surgery.

Background: Small bowel length (SBL) determines the caloric absorptive capacity. The aim of this study was to evaluate SBL to identify patient-specific predictors and the interrelationships of SBL with anthropometric variables.

Methods: Sex, age, and weight were recorded at the time of surgery when SBL and the estimated jejunal length (JLe) were measured by 3 different methods.

Single-incision laparoscopic gastric bypass for morbid obesity.

Background: Single-incision laparoscopic surgery (SILS) has been developed with the aim of reducing the invasiveness of traditional laparoscopy.

Methods: The technique of single-incision laparoscopic gastric bypass performed through a single intra-umbilical incision was adopted in 16 obese patients and minutely described. Fourteen patients underwent single-loop gastric bypass and two patients underwent "double loop" (Roux-en-Y) gastric bypass.

Laparoscopic gastric banding without visible scar: a short series with intraumbilical SILS.

Single-incision laparoscopic surgery has been developed with the aims of further reducing the invasiveness of traditional laparoscopy. The technique of lap-band placement from a single intraumbilical incision is described. Three patients underwent a single-incision laparoscopic surgery gastric banding (SILS-GB) for morbid obesity from May to September 2008.

Preinductive use of clonidine and ketamine improves recovery and reduces postoperative pain after bariatric surgery.

Background: In obese patients, concomitant use of clonidine and ketamine might be suitable to reduce the doses and minimize the undesired side effects of anesthetic and analgesic drugs. In this study, we evaluated the perioperative effects of administration of clonidine and ketamine in morbidly obese patients undergoing weight loss surgery at a university hospital in Rome, Italy.

Methods: A total of 50 morbidly obese patients undergoing open biliopancreatic diversion for weight loss surgery were enrolled.

Evaluation of antioxidant systems (coenzyme Q10 and total antioxidant capacity) in morbid obesity before and after biliopancreatic diversion.

Biliopancreatic diversion (BPD) is a surgical procedure performed in patients with untreatable obesity and insulin resistance. The demonstrated metabolic and hormonal results of this procedure include the reversal of insulin resistance; an increase in diet-induced thermogenesis; and modifications of gut hormones, such as gastrin, enteroglucagon, neurotensin, and cholecystokinin. On the other hand, obesity is a condition of increased oxidative stress; however, few studies have investigated antioxidant systems in obese persons with BPD.

Laparoscopy-assisted ERCP after biliopancreatic diversion.

Therapeutic biliary endoscopy after biliopancreatic diversion (BPD) for morbid obesity is not possible through the anatomical route. In the case of a long excluded afferent limb, the possibility to reach endoscopically the papilla through a surgical gastrostomy or jejunostomy has been reported. A case of laparoscopy-assisted ERCP performed 4 years after laparoscopic BPD with distal gastrectomy, is reported.

Body composition and energy expenditure: relationship and changes in obese subjects before and after biliopancreatic diversion.

Changes in total and segmental body composition were studied in 101 obese women before and 2, 6, 12, and 24 months after biliopancreatic diversion (BPD) and data 24 months after surgery were matched to 53 control subjects. The patients were studied by anthropometry, indirect calorimetry, and double-emission x-ray absorptiometry (DXA). The combination of calorimetry and body composition analysis allowed estimation of visceral and muscle lean mass.