Acute cholecystitis: risk factors for conversion to an open procedure.

Background: Laparoscopic cholecystectomy is one of the most common general surgical procedures performed. Conversion to an open procedure (CTO) is associated with increased morbidity and length of stay. Patients presenting with acute cholecystitis are at higher risk for CTO.

The Changing Bariatric Surgery Landscape in the USA.

The growth of bariatric surgery in the USA followed the adoption of gastric bypass (RYGB). The recent introduction of sleeve gastrectomy (SG) has been met with wide adoption. A single state report suggests that the popularity of SG has surpassed that of RYGB.

Pulmonary embolism and gastrointestinal leak following bariatric surgery: when do major complications occur?

Background: Complications following bariatric surgery are uncommon but potentially life threatening.

Objectives: The aim of this study was to assess the timing of gastrointestinal leaks (GIL) and pulmonary embolism (PE) in patients undergoing bariatric surgery.

Setting: Retrospective analysis of the nationwide American College of Surgeons National Surgical Quality Improvement Program database from 2006 to 2011.

Delayed repair of obstructing ventral hernias is associated with higher mortality and morbidity.

Background: Patients presenting with ventral hernia-related obstruction are commonly managed with emergent ventral hernia repair (VHR). Selected patients with resolution of obstruction may be managed in a delayed manner. This study sought to assess the effect of delay on VHR outcomes.

Bariatric Surgery in Patients with Dialysis-Dependent Renal Failure.

Background: Laparoscopic procedures for the treatment of morbid obesity are commonly offered to patients with comorbidities previously thought to carry prohibitive operative risk. In this study, we reviewed characteristics and perioperative outcomes of patients with dialysis-dependent renal failure (DDRF) who underwent laparoscopic bariatric procedures.

Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database from 2006 to 2011 was reviewed.

Synchronous Ventral Hernia Repair in Patients Undergoing Bariatric Surgery.

Background: Obesity predisposes patients to abdominal wall hernias. Patients undergoing bariatric surgery are not uncommonly found to have ventral hernias. Synchronous ventral hernia repair (S-VHR) has been reported in 2-5% of patients undergoing bariatric surgery.

Hyperinsulinemic syndrome: the metabolic syndrome is broader than you think.

Background: Type 2 diabetes mellitus (T2DM) is characterized by hyperinsulinemia. In 2011 we showed that gastric bypass (RYGB) corrects these high levels even though insulin resistance remains high, ie, the operation "dissociates" hyperinsulinemia from insulin resistance. RYGB produces reversal of T2DM along with other diseases associated with the metabolic syndrome.

GLP-1 response to a mixed meal: what happens 10 years after Roux-en-Y gastric bypass (RYGB)?

Background: Oral meal consumption increases glucagon-like peptide 1 (GLP-1) release which maintains euglycemia by increasing insulin secretion. This effect is exaggerated during short-term follow-up of Roux-en-y gastric bypass (RYGB). We examined the durability of this effect in patient with type 2 diabetes (T2DM) >10 years after RYGB.

Walking capacity of bariatric surgery candidates.

Background: This study characterizes the walking limitations of bariatric surgery candidates by age and body mass index (BMI) and determines factors independently associated with walking capacity. The setting was multi-institutional at research university hospitals in the United States.

Methods: Participants of the Longitudinal Assessment of Bariatric Surgery study (n=2458; age 18-78 yr, BMI 33-94 kg/m(2)) attended a preoperative research visit.

Physical activity levels of patients undergoing bariatric surgery in the Longitudinal Assessment of Bariatric Surgery study.

Background: Bariatric surgery candidates' physical activity (PA) level might contribute to the variability of weight loss and body composition changes following bariatric surgery. However, there is little research describing the PA of patients undergoing bariatric surgery to inform PA recommendations in preparation for, and following, surgery. We describe the PA assessment in the Longitudinal Assessment of Bariatric Surgery-2 study at 6 sites in the United States and report preoperative PA level.

Skeletal muscle lipid oxidation and obesity: influence of weight loss and exercise.

Obesity is associated with a decrement in the ability of skeletal muscle to oxidize lipid. The purpose of this investigation was to determine whether clinical interventions (weight loss, exercise training) could reverse the impairment in fatty acid oxidation (FAO) evident in extremely obese individuals. FAO was assessed by incubating skeletal muscle homogenates with [1-(14)C]palmitate and measuring (14)CO(2) production.

Safety and efficacy of intravascular ultrasound-guided inferior vena cava filter in super obese bariatric patients.

Background: The morbidly obese (body mass index >40 kg/m(2)) are at significant risk of postoperative venous thromboembolism (VTE). Pulmonary embolism is the leading cause of death after Roux-en-Y gastric bypass, approximating .5%.

Computer-assisted laparoscopic splenectomy with the da Vinci surgical robot.

Laparoscopic splenectomy has become the standard of care for the surgical treatment of idiopathic thrombocytopenic purpura (ITP). The minimally invasive approach to splenic disorders such as ITP clearly results in the same benefits to the patients as have been demonstrated with the laparoscopic cholecystectomy techniques. New technologies in minimally invasive surgery have resulted in the development of robotic devises that assist the surgeon during the procedures.

Early experience with telemanipulative robot-assisted laparoscopic cholecystectomy using da Vinci.

In the past decade, robot-assisted surgery has become increasingly used to assist in minimally invasive surgical procedures. In this article we review the evolution of robotic devices, from the first use of an industrial robot for stereotactic biopsies to pioneering work with robots used for hip and prostate surgery, to the development of robotic guidance systems that enabled solo endoscopic surgery, to telemanipulative surgery with master-servant computer-enhanced robotic devices. In addition, we review our early experience with da Vinci Robotic Surgical Systems (Intuitive Surgical, Inc.

Robotic-assisted adrenalectomy for adrenal incidentaloma: case and review of the technique.

An incidental left adrenal mass was found in a patient during an evaluation for mediastinal widening. The patient had no symptoms attributable to adrenal excess. Preoperative biochemical screening was negative for a functioning medullary or cortical adrenal tumor.

Analysis of microliter volumes of dye-labeled nucleic acids.

We describe methodology useful for determining the fluorescent activity of small volumes (e.g., 1 microL) of dye-labeled cDNAs using microabsorbance spectroscopy.

Mesolytic Scission of C-C Bonds as a Probe for Photoinduced Electron Transfer Reactions of Quinones.

Photoinduced electron transfer reactions of chlorinated benzoquinones are investigated using bibenzylic donors that undergo rapid fragmentation upon oxidation. The fragmentation rates and the quantum yields are used to probe the dynamics of back-electron transfer (BET) in two types of radical ion pairs. The triplet ion pairs formed by interception of excited state quinones give products with high quantum yields.