Super obesity and gastric reduction procedures.

Identification and designation of those patients whose estimated ideal weight exceeds 225 per cent as super obese has improved our evaluation of operations designed for treatment of obesity. It has also allowed a more realistic prediction of results, and provided a basis for further study of both the need for, and effectiveness of, further modification of operative treatment of these extremely heavy people. The super obese patient provides a severe test for operative weight control.

Evaluation of an emergency air transport service as a component of a rural EMS system.

The authors reviewed the records of 569 patients transported by an emergency helicopter service to evaluate its impact on the outcome of patients with multisystemic injuries. A Total Trauma Score for each patient was computed. A number of other factors were also considered, including the nature of the injury, number of systems injured, origin and duration of flight, resuscitative maneuvers, number of blood transfusions given and the timing of operations required to treat the injury.

Gastric bypass criteria for effectiveness.

Weight loss patterns and revision rates in three sequential groups of patients with gastric bypasses and loop gastroenterostomies between 1965 and 1978 demonstrate the importance of a 50 ml volume of the upper segment measured at 25 to 30 cm water luminal pressure and a 10 to 12 mm diameter stoma. The need for a secure partition is well known. Reinforcement of the stoma to prevent dilation has contributed greatly to the success of gastroplasty and should be studied in gastric bypass.

Gastric bypass in morbid obesity.

Gastric operations for the treatment of morbid obesity have been standardized. They require close adherence to specifications for success. The upper stomach volume should be measured intraoperatively and fashioned to a capacity of 50 ml at a pressure of 25 to 30 cm of saline.