ABSTRACT
BACKGROUND: Sleeve gastrectomy is one of the most popular bariatric surgeries. With the advent of new technologies, a reduced-port approach assisted by magnets for sleeve gastrectomy (RPSG-MA) has been developed. The aim of our study is to compare the short-term results of RPSG-MA vs conventional laparoscopic SG (CLSG). METHODS: A comparative study was performed. We compared two groups who underwent RPSG-MA (n=150) and CLSG (n=135) between January 2020 and January 2022. RESULTS: Both groups were similar in body mass index, age, sex, and type of comorbidities. The operative time was similar in both groups (RPSG-MA, 52.5 min vs CLSG, 52.9 min; p = 0.829). Length of hospital (1.07 days) stay was significantly shorter in the RPSG-MA group (p = 0.00) than in the CLSG group (1.51 days). There were no conversions to open surgery in any patient or any fatal event. Complications encountered were similar in both groups postoperative. There were minor adverse events directly related to the magnetic device in 3 cases, these being mild hepatic lacerations, resolved with hemostatic measures. CONCLUSION: The magnet-assisted reduced-port gastric sleeve compared to the conventional technique has proven to be safe, technically feasible and with multiple benefits.
Subject(s)
Bariatric Surgery , Laparoscopy , Obesity, Morbid , Humans , Obesity, Morbid/surgery , Laparoscopy/methods , Gastrectomy/methods , Bariatric Surgery/methods , Magnetic Phenomena , Retrospective Studies , Treatment OutcomeABSTRACT
Roux-en-Y gastric bypass (RYGB) is one of the best procedures for the treatment of obesity and associated comorbidities. However, the percent of revisional procedures after a gastric bypass by weight regain has been increased, therefore several surgical options are available for the treatment of weight regain. In this case report, we combined a biliary limb distalization with endoscopic transoral outlet reduction (eTOR). The purpose of this case report is to expose the viability to perform combined procedures such as the distalization of the biliopancreatic limb plus eTOR increasing malabsorptive and restrictive components that would represent a secure and efficient weight loss in our patient. We could demonstrate the technical feasibility of the combination of both procedures to increase the restrictive and malabsorptive components at the same time with a low-risk range.
ABSTRACT
INTRODUCTION: Obesity has experienced worldwide increase and surgery has become the treatment that has achieved the best results. Several techniques have been described; the most popular are vertical gastrectomy (GV) and the Roux-en-Y gastric bypass (RYGB). However, mini-gastric bypass/one anastomosis gastric bypass (MGB/OAGB) has gained popularity due to its simplicity and good results. OBJECTIVE: To comparatively evaluate the results of MGB/OAGB with those of RYGB with 1-year follow-up. METHODS: The paper presents a comparative case and control study of 100 patients that underwent MGB/OAGB surgery and another 100 with RYGB surgery, operated between 2008 and 2016. Patients were not submitted to revision surgery and had the following pre-operative variables: age 40.46 ± 12.4 vs. 39.43 ± 10.33 years; sex 64 and 54 women, 36 and 46 men; BMI 44.8 ± 12.06 and 45.29 ± 8.82 kg/m2; 50 and 54 cases with comorbidities, respectively, these being non-significant differences. RESULTS: The surgical time was 69.01 ± 4.62 (OAGB) vs. 88.98 ± 3.44 min; the time of hospitalization was 2 days, reaching a BMI of 27.7 ± 7.85 and 29 ± 4.52 kg/m2, with an excess weight loss 1 year after surgery of 89.4 vs. 85.9%, respectively. The morbidity rates are 9% for OAGB and 11% for the RYGB. There was a comorbidity resolution of 84.4 and 83.7% respectively, without mortality. CONCLUSIONS: The results show the benefits of both techniques, OAGB being the easiest to perform and with less surgical time.