ABSTRACT
BACKGROUND: Adjustable silicone gastric banding (ASGB) has been advocated as a minimally invasive procedure that is completely reversible for the surgical treatment of morbid obesity. Band erosion (BE) is one of the possible complications of ASGB. The authors report their experience with BE and discuss its possible causes. METHODS: Between February 1993 and February 1998, the authors performed 122 ASGB: 51 open and 71 laparoscopic procedures. RESULTS: Two cases of BE occurred (1.6%). CONCLUSION: Band erosion is a possible complication of ASGB that is often not diagnosed immediately. Prevention is essential and consists primarily in correct placement of the band. There appears to be only one solution to BE: removal of the band. Placement of a new band after removal is possible; the minimum interval is not known.
Subject(s)
Foreign Bodies/etiology , Foreign-Body Migration/surgery , Gastroplasty/adverse effects , Gastroplasty/instrumentation , Obesity, Morbid/surgery , Silicones , Stomach , Adult , Body Mass Index , Endoscopy, Gastrointestinal , Equipment Failure , Evaluation Studies as Topic , Female , Follow-Up Studies , Foreign Bodies/surgery , Foreign-Body Migration/etiology , Gastroplasty/methods , Humans , Laparoscopy/methods , Male , Obesity, Morbid/diagnosisSubject(s)
Obesity, Morbid/history , Belgium , General Surgery/history , History, 20th Century , Humans , Obesity, Morbid/surgeryABSTRACT
From april 1992 to april 1994 we performed 120 laparoscopic transperitoneal hernia repairs using a polypropylene mesh. This paper is a preliminary review of the method we used and our results. We operated upon 105 patients including 40 direct, 79 indirect and 1 femoral hernias. The inguinal region is approached transperitoneally through 3 trocars placed in the lower abdominal region. A dissection of the pre-peritoneal inguinal space is performed and a 14 x 8 cm mesh is fixed using a stapling device. We have had some peroperative complications (injury to the epigastric vessels and the vas deferens, bowel injury), mainly in our early experience with this new technique. Postoperative complications consisted of minor problems (scrotal seroma and induration of the spermatic cord) 3 infections, 1 patient with prolonged pain and 1 recurrence. Some of these problems can be resolved by adjusting the technique. There seems to be less postoperative pain and a shorter convalescence period allowing active persons to return to work earlier than with classic herniorrhaphy. Since this is a new technique, no definite conclusions can be drawn at the moment.
Subject(s)
Hernia, Inguinal/surgery , Laparoscopy/methods , Surgical Mesh , Adult , Aged , Aged, 80 and over , Groin/anatomy & histology , Hernia, Inguinal/diagnostic imaging , Humans , Middle Aged , Polypropylenes/therapeutic use , Tomography, X-Ray ComputedSubject(s)
Ileum/surgery , Jejunum/surgery , Obesity/therapy , Postoperative Complications , Female , Humans , MaleABSTRACT
Obese people, more than 45 kg above their ideal weight, can be treated by an intestinal by-pass. This operation must be reserved for patients where conservative treatment failed, where there is no organic origin, and given the operative risk be not increased by underlying serious disease. Good pre- and postoperative collaboration of the patient together with clinical and biological controls are essential. The operation consists of an end-to-side jejuno-ileostomy with proximal suture of the blind loops; or an end-to-end jejuno-ileostomy with implantation of the blind loops in the colon. Loss of weight to near ideal plus improvement of diabetes, hypertension, gout and hyperlipaemia can be expected. Diarhea will occur for a few months or one year. Biochemical values usually remain stable: values for lipids decrease to lower normal if elevated before the operation. During fast weight loss, there are changes in the liver structure and hepatic tests; these are transient and reversible.
