ABSTRACT
BACKGROUND: The aim of the study was to prospectively evaluate the feasibility and clinical efficacy of a strategy of performing simultaneous balloon removal and sleeve gastrectomy in the super-super obese patients. METHODS: Forty consecutive super-super obese patients underwent intra-gastric balloon insertion followed by simultaneous balloon removal and sleeve gastrectomy 6 months later. RESULTS: Balloon insertion resulted in a reduction in mean body mass index from 69.3 ± 1.4 to 62.3 ± 1.3 kg/m2. Simultaneous balloon removal and sleeve gastrectomy was achieved in 39 cases. There were no operative mortality and no leaks. Six months following sleeve gastrectomy, the mean BMI of the cohort had fallen to 54.1 ± 1.2 kg/m2. CONCLUSIONS: Simultaneous balloon removal and sleeve gastrectomy in the super-super obese patients is feasible as a single-stage procedure with good perioperative outcomes.
Subject(s)
Body Mass Index , Device Removal/methods , Gastric Balloon , Gastroplasty/methods , Laparoscopy , Obesity, Morbid/surgery , Feasibility Studies , Female , Humans , Male , Middle Aged , Prospective Studies , Severity of Illness Index , Treatment OutcomeABSTRACT
Objective. The demand for laparoscopic surgery has led to the core laparoscopic skills course (CLSC) becoming mandatory for trainees in UK. Virtual reality simulation (VR) has a great potential as a training and assessment tool of laparoscopic skills. The aim of this study was to determine the role of the CLSC in developing laparoscopic skills using the VR. Design. Prospective study. Doctors were given teaching to explain how to perform PEG transfer and clipping skills using the VR. They carried out these skills before and after the course. During the course they were trained using the Box Trainer (BT). Certain parameters assessed. Setting. Between 2008 and 2010, doctors attending the CLSC at St Georges Hospital. Participants. All doctors with minimal laparoscopic experience attending the CLSC. Results. Forty eight doctors were included. The time taken for the PEG skill improved by 52%, total left hand and right hand length by 41% and 48%. The total time in the clipping skill improved by 57%. Improvement in clips applied in the marked area was 38% and 45% in maximum vessel stretch. Conclusions. This study demonstrated that CLSC improved some aspects of the laparoscopic surgical skills. It addresses Practice-based Learning and patient care.
