silicon and Obesity--Morbid

Some sort of restriction of the pouch emptying is supported by many surgeons to allow a sustained weight loss through the use of a ring placed circumferentially around the gastric pouch. Most previous studies focused on the length of the ring, not the actual diameter of the gastric pouch outlet. This study aims to evaluate the association between the actual diameter of the gastric pouch outlet and the weight loss in obese patients submitted to silicon ring Roux-en-Y gastric bypass. We studied prospectively 257 patients that underwent silicon ring (65 mm) Roux-en-Y gastric bypass between July 2005 and August 2007. Upper digestive endoscopy was performed to measure the diameter of the gastric pouch outlet at 1 and 2 years with the aid of calibrated balloons. The diameter of the gastric pouch outlet ranged from 9 to 14 mm (mean = 11 mm). Excess weight loss ranged from 37% to 127% (mean = 69%) during the first year and 29% to 110% (mean = 69%) during the second year. A negative correlation between the diameter of the gastric pouch outlet and excess weight loss at first year (r = -0.792, p < 0.001) and at the second year of follow-up (r = -0.921, p < 0.001) was found. The actual diameter of the gastric pouch outlet was associated with weight loss after silicon ring Roux-en-Y gastric bypass during the 2-year follow-up.

Topics: Adolescent; Adult; Aged; Body Mass Index; Female; Gastric Bypass; Gastroscopy; Humans; Male; Middle Aged; Obesity, Morbid; Silicon; Stomach; Weight Loss; Young Adult

Laparoscopic adjustable gastric banding is a safe and effective treatment method for morbid obesity. Injection port dislocation, tube perforation and access port infection are generally classified among the minor complications, although they can require a reoperation at the port-site or even at the level of the band which may have to be removed. We designed a technique to fix the port, that can avoid unnecessary complications.. The port is sutured onto a polyprophlene mesh, which is then cut into shape and attached to the rectus fascia in the left hypochondrium with a Tacker stapling device. From February 2000 to January 2001, 25 patients (BMI 35-60) were operated using this technique.. No injection port dislocation, tube perforation or access port infection has been found in these patients.. With the larger surface area by which the port is attached to the fascia, a stable position of the port is obtained and dislocation avoided. Multiple failed attempts at port access, with resulting risk of infection, are avoided. Due to port stability, risk of incidental tube perforation is reduced. Moreover, a considerable gain of time is obtained compared with the classical suturing of the port.

Topics: Bandages; Body Mass Index; Catheters, Indwelling; Equipment Failure; Humans; Laparoscopy; Obesity, Morbid; Postoperative Complications; Silicon; Stomach; Surgical Stapling; Surgical Wound Infection

Topics: Gastroplasty; Humans; Obesity, Morbid; Radiography; Silicon; Stomach