New approach in surgical treatment of morbid obesity: laparoscopic adjustable silicone gastric banding [LASGB]

Kuzmak's Adjustable Silicone Gastric Banding [ASGB] is the least invasive operation available for morbid obesity. The results of weight loss following gastric banding in patients with morbid obesity were similar to patients treated by gastroplasty in the literature. Twenty-six patients had undergone gastric banding for morbid obesity, the first six patients by open surgery and the remaining were approached laparoscopically. Average preoperative body mass index [BMI] was 50.6 kg/m2 and average preoperative weight was 137.2 kg. After one year follow up, the mean postoperative BMI reached 37.6 kg/m2 and the mean postoperative weight loss was 35.5 kg. Blood pressure significantly decreased from the mean 153/98 to 132/88. There were no significant changes noted in the follow up laboratory results concerning transaminases, electrolytes red blood cell count. Two patients were converted from laparoscopic approach to open surgery [10%]. There were postoperative wound complications in three patients and gastric perforation in one patient. The laparoscopic technique enabled them to shorten the hospital stay and decreased the postoperative complications with the same good weight- loss results after open laparotomy gastric banding

Fibrinolytic activity in obliterative arterial diseases

This study was designed with the aim of assessing the fibrinolytic status of patients suffering from obliterative arterial disease [OAD] as compared to healthy controls. Twenty-five patients with arterial obliterative diseases presented acutely were chosen for fibrinolytic assay and compared with 25 healthy controls. Twelve patients had critical ischemia and 15 patients were diabetics. Twenty-one patients had lower limb ischemia while, 4 patients had upper limb ischemia. The results of the study suggested that the fibrinolytic system is significantly impaired in cases of acute or severely ischemic patients when compared to controls. It was concluded that fibrinolytic assay could be added as a routine investigation in cases of critical ischemia and early onset atherosclerosis. Therapeutic options could be adjusted according to the fibrinolytic assay results