Safety and Efficiency of an Articulating Needle Driver in Advanced Laparoscopic Abdominal Surgery.

Robotic platforms offer articulating needle drivers but are associated with high costs and lack tactile feedback. The recently developed mechanical Laparoscopic Articulating Needle Driver (LAND) (Flexdex) for conventional laparoscopy offers enhanced dexterity without these limitations. The goal of this study was to assess safety and efficiency during the implementation of the LAND, and describe its learning curve, in an expert center for laparoscopic surgery.

[Weight gain after bariatric surgery].

Despite the frequent success of bariatric surgery, 20-30% of patients do not respond well. These patients may experience insufficient weight loss, defined as primary non-response, or may regain an excessive amount of weight after sufficient weight loss, defined as secondary non-response. The aetiology and subsequent treatment of these two types of non-response may differ.

The Acute Abdomen in Pregnant Women After Roux-en-Y Gastric Bypass: Encouraging Results from a National Referral Centre.

Background: Pregnant women with a history of bariatric surgery (BS) may develop acute abdominal pain related to this surgery, especially after Roux-en-Y gastric bypass. Studies showed alarming results regarding maternal and foetal morbidity and mortality. The aim of this study was to analyse these outcomes for pregnant women and their offspring.

Primary and Secondary Nonresponse Following Bariatric Surgery: a Survey Study in Current Bariatric Practice in the Netherlands and Belgium.

Purpose: Primary nonresponse (1NR) - inability to achieve adequate weight loss after surgery - and secondary nonresponse (2NR) - excessive weight regain after initial adequate weight loss after surgery - can occur in up to 25-35% of patients after bariatric surgery. The aim of this study was to explore the variations in both definition as well as management of 1NR and 2NR amongst bariatric surgeons.

Materials And Methods: An online survey was distributed to all members of the national bariatric societies in the Netherlands and Belgium regarding questions about definition, work-up and treatment of 1NR and 2NR after bariatric surgery.

Pregnant patient with acute abdominal pain and previous bariatric surgery.

Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy. Two patients, 38-year-old twin primigravida (gestational age of 24+6 weeks) and a 26-year-old woman (gestational age of 24+0 weeks), both of whom had laparoscopic gastric bypass surgery previously, developed abdominal pain. The patients both had diffuse abdominal pain in combination with normal blood tests and imaging.

Diet-Induced Alteration of Microbiota and Development of Obesity, Nonalcoholic Fatty Liver Disease, and Diabetes: Study Protocol of a Prospective Study.

Background: Development of obesity and obesity-related diseases, such as type 2 diabetes mellitus and nonalcoholic fatty liver disease (NAFLD), is associated with altered gut microbiota composition. The aim of this study is to investigate associations among dietary compounds, intestinal cell function, and gut microbiota composition. We hypothesize that dietary lipid intake is associated with Paneth cell and goblet cell properties that affect gut microbiota composition.

Reliability and usefulness of upper gastro intestinal contrast studies to assess pouch size in patients with weight loss failure after Roux-en-Y gastric bypass.

Weight loss failure or weight regain occurs in up to 25% of patients with a Roux-en-Y gastric bypass (RYGB). Post-operative anatomical changes, like pouch or stoma dilatation, might contribute. Aim of this study is to assess reliability and usefulness of upper gastro intestinal (UGI) contrast studies to detect pouch dilatation.

Lack of Standard Definitions of Primary and Secondary (Non)responders After Primary Gastric Bypass and Gastric Sleeve: a Systematic Review.

Lack of standard definitions of primary and secondary (non)responders after RYGB and SG makes it impossible to compare the literature. The aim was to analyze the different definitions used. MEDLINE® was searched for literature published between 01-07-2014 and 01-07-2017 concerning (1) patients who received a primary RYGB or SG and (2) the outcomes of primary and secondary (non)responders.

[Abdominal pain in a pregnant patient who had gastric reduction surgery: risks associated with a history of bariatric surgery].

Pregnant women who previously had bariatric surgery may develop acute abdominal pain during pregnancy that may be related to previous operations. Two patients, a 38-year-old twin-primigravida who had a gestation period of 24+6 weeks and a 26-year-old woman who had a gestation period of 24 weeks, both of whom had laparoscopic gastric bypass (RYGB) surgery 2 and 3 years previously, developed abdominal pain. The patients were not ill, but had diffuse abdominal pain in combination with normal blood tests and imaging.

Laparoscopic Adjustable Gastric Banding After Failed Roux-En-Y Gastric Bypass.

Background: Roux-en-Y gastric bypass (RYGB) is associated with approximately 25 % weight loss failure, resulting in insufficient weight loss or weight regain. Strategies of revisional surgery focus on alteration of limb length, pouch or stoma size. Altering pouch size and outlet by adding laparoscopic adjustable gastric band (LAGB) might initiate further weight loss.

Loss of Skeletal Muscle Mass During Neoadjuvant Chemoradiotherapy Predicts Postoperative Mortality in Esophageal Cancer Surgery.

Background: Esophageal surgery is associated with complications and mortality. It is highly important to develop tools predicting unfavorable postoperative outcome. Esophageal cancer and neoadjuvant chemoradiotherapy (CRT) induce skeletal muscle wasting, which leads to diminished physiologic reserves.

Sentinel bleeding as a sign of gastroaortic fistula formation after oesophageal surgery.

Gastroaortic fistula formation is a very rare complication following oesophageal resection and, in most cases, leads to sudden death. We report the case of a 65-year-old male with an adenocarcinoma of the oesophagus who underwent neoadjuvant chemoradiation followed by a minimally invasive transthoracic oesophagectomy with gastric tube reconstruction and intrathoracic anastomosis. After an uneventful postoperative course and hospital discharge, the patient reported blood regurgitation on postoperative day 23.