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1.
J Gastrointest Surg ; 28(5): 640-650, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38704201

RESUMO

BACKGROUND: Single-anastomosis metabolic/bariatric surgery procedures may lessen the incidence of anastomotic complications. This study aimed to evaluate the feasibility and safety of performing side-to-side duodenoileal (DI) bipartition using magnetic compression anastomosis (MCA). In addition, preliminary efficacy, quality of life (QoL), and distribution of food through the DI bipartition were evaluated. METHODS: Patients with a body mass index (BMI) of ≥35.0 to 50.0 kg/m2 underwent side-to-side DI bipartition with the magnet anastomosis system (MS) with sleeve gastrectomy (SG). By endoscopic positioning, a distal magnet (250 cm proximal to the ileocecal valve) and a proximal magnet (first part of the duodenum) were aligned with laparoscopic assistance to inaugurate MCA. An isotopic study assessed transit through the bipartition. RESULTS: Between March 14, 2022 to June 1, 2022, 10 patients (BMI of 44.2 ± 1.3 kg/m2) underwent side-to-side MS DI. In 9 of 10 patients, an SG was performed concurrently. The median operative time was 161.0 minutes (IQR, 108.0-236.0), and the median hospital stay was 3 days (IQR, 2-40). Paired magnets were expelled at a median of 43 days (IQR, 21-87). There was no device-related serious advanced event within 1 year. All anastomoses were patent with satisfactory diameters after magnet expulsion and at 1 year. Respective BMI, BMI reduction, and total weight loss were 28.9 ± 1.8 kg/m2, 15.2 ± 1.8 kg/m2, and 34.2% ± 4.1%, respectively. Of note, 70.0% of patients reported that they were very satisfied. The isotopic study found a median of 19.0% of the meal transited through the ileal loop. CONCLUSION: Side-to-side MCA DI bipartition with SG in adults with class II to III obesity was feasible, safe, and efficient with good QoL at 1-year follow-up. Moreover, 19% of ingested food passed directly into the ileum.


Assuntos
Anastomose Cirúrgica , Duodeno , Estudos de Viabilidade , Gastrectomia , Imãs , Humanos , Gastrectomia/métodos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Duodeno/cirurgia , Anastomose Cirúrgica/métodos , Seguimentos , Obesidade Mórbida/cirurgia , Íleo/cirurgia , Qualidade de Vida , Laparoscopia/métodos , Índice de Massa Corporal , Duração da Cirurgia , Cirurgia Bariátrica/métodos , Resultado do Tratamento , Trânsito Gastrointestinal
2.
Obes Surg ; 34(2): 635-642, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38183593

RESUMO

In the context of escalating obesity rates, bariatric surgery holds a crucial role in managing severely obese patients. With a demonstrated effectiveness in weight loss and with the advent of ambulatory surgery, bariatric surgery allows for a streamlined care pathway, ideally suited for postoperative surveillance using digital health applications. The aim of this systematic review and meta-analysis is to evaluate the effect of eHealth-delivered health services or support for adults undergoing bariatric surgery. Five studies, encompassing 2210 patients, were analysed. The intervention group showed a 10% increase in total weight reduction and a 22% reduction in excess weight loss. ED visitation rates also trended towards reduction. Despite the absence of clear statistical superiority for DHA, the findings suggest potential benefits of DHA in postoperative monitoring.


Assuntos
Cirurgia Bariátrica , Avaliação de Resultados em Cuidados de Saúde , Adulto , Humanos , Obesidade Mórbida/cirurgia , Redução de Peso
3.
Surg Endosc ; 37(10): 7812-7818, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-37605013

RESUMO

BACKGROUND: Over the past 20 years, surgeons involved in soft tissue minimally invasive surgery have experienced the pros and cons of both conventional and tele-robotic laparoscopic approaches. The Maestro System, developed by Moon Surgical (Paris, France) aims to overcome the challenges inherent to both approaches thanks to a new concept that augments the surgeon's performance at the bedside during a laparoscopic procedure. METHODS: The current study aims to present the first human experience with laparoscopic cholecystectomy with the Maestro system on 10 patients. RESULTS: All ten procedures were completed successfully. No significant complications related to the use of the Maestro system werenoted. CONCLUSION: Our preliminary observations appear to support the benefits of the Maestro system in non-emergent laparoscopic cholecystectomies. It goes without saying that further research is necessary to demonstrate the safety of this approach in other procedures.


Assuntos
Colecistectomia Laparoscópica , Laparoscopia , Robótica , Cirurgiões , Humanos , Colecistectomia Laparoscópica/métodos , Laparoscopia/métodos , Robótica/métodos , França
4.
J Surg Case Rep ; 2023(6): rjad305, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37337539

RESUMO

Laparoscopic cholecystectomy (LC) is one of the most commonly performed surgical procedures worldwide. A previous abdominal operation is not considered a significant risk factor for conversion to open cholecystectomy. We describe the case of an 80-year-old woman with a surgical history of a giant uncomplicated incisional midline hernia presenting at our department with choledocholithiasis and acute cholangitis. After an ERCP with extraction of common bile duct stones, a LC was planned. The first trocar was inserted in the right midclavicular line, using an open technique and a careful inspection of the abdominal cavity and the hernia sac content. An uncomplicated cholecystectomy was performed and the postoperative course was uneventful.

5.
Obes Surg ; 31(10): 4511-4518, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374929

RESUMO

PURPOSE: The COVID-19 pandemic caused a lockdown in many countries, which induced negative dietary habits and sedentary behavior. Studies suggest that weight loss of patients undergoing bariatric surgery was equally affected. The aim was to evaluate the impact of COVID-19 on weight loss, obesity-related comorbidities, and nutritional status at 1-year follow-up after gastric bypass (GB). METHODS: Retrospective observational case-control study of patients undergoing primary GB in a tertiary referral Belgian center. COVID-19 period group was composed by those whose 1-year postoperative period was affected by the COVID-19 pandemic and lockdown: from October 1, 2019, to March 31, 2020. The control group was composed of patients operated from October 1, 2018, to March 31, 2019. Electronic clinical records were reviewed searching: baseline characteristics, weight and comorbidities evolution, and biochemical values. RESULTS: A total of 47 patients in the COVID-19 period group and 66 in the non-COVID-19 period group were analyzed. There were no significant differences in baseline characteristics. A reduced weight loss was observed at 1-year follow-up, in terms of percentage of excess weight loss (%EWL) (82.4% [SD: 21.6] vs. 82.4% [SD: 21.6]; p: 0.043) and body mass index (BMI) (27.8 kg/m2 [IQR: 25.8-30.0] vs. 26.2 kg/m2 [IQR: 24.6-28.6]; p: 0.029) for COVID-19 period group vs. non-COVID-19 period group, respectively. There was a similar reduction of obesity-related comorbidities, without clinically significant differences in the nutritional follow-up. CONCLUSION: The COVID-19 pandemic and lockdown had an impact on weight loss at 1-year follow-up after gastric bypass.


Assuntos
COVID-19 , Derivação Gástrica , Laparoscopia , Obesidade Mórbida , Índice de Massa Corporal , Estudos de Casos e Controles , Controle de Doenças Transmissíveis , Seguimentos , Humanos , Obesidade Mórbida/cirurgia , Pandemias , Estudos Retrospectivos , SARS-CoV-2 , Resultado do Tratamento
7.
J Laparoendosc Adv Surg Tech A ; 31(11): 1262-1268, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33428516

RESUMO

Introduction: Trauma is a leading cause of death in young patients. The prevalence of blunt and penetrating trauma varies widely across the globe. Similarly, the global experience with laparoscopy in trauma patients also varies. There is a growing body of evidence to suggest that laparoscopy is feasible in trauma patients. We sought to contribute to these data by reporting our experience with laparoscopic management of blunt and penetrating trauma in a Belgian center. Materials and Methods: We retrospectively collected data on all trauma patients admitted to the Saint-Pierre University Hospital in Brussels, Belgium, over the 4-year period from January 2014 to December 2017. Hospital records for patients subjected to exploratory laparoscopy were retrospectively reviewed, and a descriptive analysis was reported. Results: There were 26 patients at a mean age of 40 years treated with laparoscopic exploration for injuries from blunt trauma (7), stab wounds (14), and gunshot injuries (5). The median interval between the arrival at the emergency unit and diagnostic laparoscopy was 175 minutes (range: 27-1440), and the median duration of operation was 119 minutes (range: 8-300). In all patients who underwent laparoscopy for trauma, there were 27% overall morbidity, no mortality, 11% reoperation rate, 7.4% conversions, and 19% incidence of negative laparoscopy. The median intensive care unit stay was 3 days (range: 0-41), and median total hospital stay was 7 days (range: 2-78). Conclusions: Laparoscopy is a safe, feasible, and effective tool in the surgical armamentarium to treat hemodynamically stable patients with blunt and penetrating abdominal trauma. It allows complete and thorough evaluation of intra-abdominal viscera, reduces the incidence of nontherapeutic operations, and allows therapeutic intervention to repair a variety of injuries. However, it requires appropriate surgeon training and experience with advanced laparoscopic techniques to ensure good outcomes.


Assuntos
Traumatismos Abdominais , Laparoscopia , Ferimentos Penetrantes , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/cirurgia , Adulto , Humanos , Laparotomia , Estudos Retrospectivos , Ferimentos Penetrantes/cirurgia
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