The effect of Roux-en-Y gastric bypass on prescription drug costs.

Background: This study examines the effect of weight loss following laparoscopic Roux-en-Y gastric bypass (RYGBP) for morbid obesity on prescription drug costs in patients over the age of 54.

Methods: 78 patients aged 55 to 75 who met the inclusion criteria were identified in a database of 1,060 morbidly obese patients undergoing LRYGBP between March 2001 and March 2003. All prescription drugs and dosages were recorded preoperatively and postoperatively at 6 months, 1 year, and yearly thereafter.

Comparison of insufflation vs. retractional technique for laparoscopic-assisted intervertebral fusion of the lumbar spine.

Laparoscopic transperitoneal fusion of the L5-S1 spinal interspace has become a common procedure. Retroperitoneal retraction and laparoscopic instrumentation without insufflation also allows visualization of the upper lumbar spaces, but this procedure is much more difficult to accomplish. We review and compare our results using each of these techniques for the treatment of mechanical instability and chronic back pain.

Balloon-tipped cannulas for use in laparoscopic diagnosis and treatment of acute upper GI bleeding.

Background: Percutaneous balloon-tipped laparoscopic cannulas designed for preperitoneal hernia repair can be readily used to treat gastric bleeding laparoscopically.

Methods: Between 1995 and 1997, we successfully used balloon-tipped cannulas to visualize, biopsy, and suture acutely bleeding gastric lesions in five patients. These case histories are reviewed for this study.

Comparison of insufflation vs retractional technique for laparoscopic-assisted intervertebral fusion of the lumbar spine.

Laparoscopic transperitoneal fusion of the L5-S1 spinal interspace has become a common procedure. Retroperitoneal retraction and laparoscopic instrumentation without insufflation also allows visualization of the upper lumbar spaces, but this procedure is much more difficult to accomplish. We review and compare our results using each of these techniques for the treatment of mechanical instability and chronic back pain.

Management of bile duct stones in 1572 patients undergoing laparoscopic cholecystectomy.

Evidence of bile duct stones (BDSs) was identified on routine cholangiogram in 136 (8.7%) of 1572 patients undergoing laparoscopic cholecystectomy from March 1989 through March 1997. Forty-two (30.

Directional atherectomy and balloon angioplasty for lower extremity arterial disease.

This study was undertaken to evaluate the use of directional atherectomy, balloon angioplasty, and video angioscopy in highly selected patients with superficial and popliteal artery stenoses. Directional atherectomy and balloon angioplasty for superficial femoral and popliteal artery stenosis (> 80%) were performed in 96 limbs (88 patients) between 1990 and 1994. All procedures were performed by the authors with angioscopy and C-arm angiography.

Laparoscopic reconstruction of gastroesophageal anatomy for the treatment of reflux disease.

This paper presents the technique and results of an operation that restores normal anatomical and physiological antireflux mechanisms for the treatment of gastroesophageal reflux disease (GERD). The Hill procedure was modified beginning in 1973, evolving into an operation that has been standard in our practice since 1987. Major changes included total fixation of the abdominal esophagus and elimination of phrenoesophageal bundle plication.

Concomitant renal endarterectomy and aortic reconstruction.

Purpose: This retrospective study is to determine the efficacy and durability of renal endarterectomy in patients undergoing simultaneous aortic reconstruction. In addition, the operative risk to patients with symptomatic and asymptomatic renal artery stenosis is evaluated.

Methods: The results of a retrospective study of 101 patients who underwent combined procedures are presented.

Impact of a growing elderly population on nursing.

Medical advances have promoted longer, healthier lives with fewer diseases and more treatable illnesses for humans. Long-term care and chronic illnesses are becoming more common, increasing the need for nursing care of a growing elderly population. Nurses in all areas of specialization must be prepared to face these challenges and provide health care in an ethical manner.

Preventing violence in hospitals.

The author discusses the areas of potential concern and why it is necessary to have a plan in place in advance. In this day and age, security must be prepared to handle violent situations in the hospital setting.

Hypospadias repair. Preoperative preparation, intraoperative techniques, postoperative care.

The location of the defect and the need for surgery causes these children and their parents more emotional concern than the actual defect. Voiding usually prevents no problem, especially because they are still in diapers. Children this age are not affected by an altered body image, but their parents' are concerned about their children having an acceptable physical appearance and adequate future sexual competency.