Obesity Surgery最新文献

{"title":"Robotic Use, Operative Length, and Readmission after Duodenal Switch: A Retrospective Ten-Year MBSAQIP Analysis Using an Interaction Model.","authors":"Samuel Leslie, Sruthi Shankar, Jordan Sauve, Amogh Kalyanam, Sayeed Ikramuddin, Eric Wise","doi":"10.1007/s11695-026-08921-w","DOIUrl":"10.1007/s11695-026-08921-w","url":null,"abstract":"<p><strong>Background: </strong>Robotic-assisted surgery (RAS) is increasingly used in bariatric practice, yet its impact on outcomes after duodenal switch (DS) remains poorly characterized, and whether operative length (OL) modifies the RAS-outcome association has not been assessed. The present study examines the independent and interactive effects of RAS and OL on 30-day readmission after DS using a national cohort of over 17,000 cases from the MBSAQIP database spanning 2015-2024.</p><p><strong>Methods: </strong>We analyzed MBSAQIP data from 2015 to 2024 for patients undergoing laparoscopic DS (CPT 43845), excluding open, endoscopic, hand-assisted, and single-incision, revision, and conversion cases. Multivariable logistic regression assessed predictors of 30-day readmission, with a pre-specified interaction term between RAS and standardized OL to isolate the independent contribution of robotic use.</p><p><strong>Results: </strong>Among 17,615 DS cases, 5,496 (31.2%) were robotic-assisted. Thirty-day readmission was higher after RAS than laparoscopic DS (6.2% vs. 5.0%, p < 0.01). In adjusted models, RAS (OR 1.78, 95% CI 1.25-2.55, p < 0.05) and OL (OR 1.27 per standard deviation (SD), 95% CI 1.18-1.38, p < 0.001) were independently associated with increased odds of readmission. The RAS-OL interaction significantly improved model fit (likelihood ratio p = 0.007); each SD decrease in OL increased the relative readmission risk for RAS versus laparoscopic cases (interaction OR 0.79, 95% CI 0.67-0.94, p < 0.05). Temporal subgroup analysis shows this disadvantage was concentrated in 2015-2019.</p><p><strong>Conclusions: </strong>RAS for DS is associated with higher 30-day readmission, and OL significantly modifies this relationship. The interaction term suggests that improved operative efficiency will not resolve the RAS readmission disadvantage.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5388-5395"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Comparative Clinical Effectiveness and Operating Efficiency of Different Ultrasonic Devices for Performance of Sleeve Gastrectomy.","authors":"Monali Misra, I-Wen Pan, Zasim Azar Siddqui, Frank Bisceglie, Matthew Kroh","doi":"10.1007/s11695-026-08911-y","DOIUrl":"10.1007/s11695-026-08911-y","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5183"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Sleeve Gastrectomy on Cognitive Function, Metabolic Indexes and Related Hormones in Adolescents with Obesity.","authors":"Shixing Zhao, Haowen Gao, Guiqi Wang, Haobing Guo, Liyun Pang, Wei Wang, Jingfeng Gu","doi":"10.1007/s11695-026-08928-3","DOIUrl":"10.1007/s11695-026-08928-3","url":null,"abstract":"<p><strong>Objective: </strong>Adolescent obesity is closely associated with cognitive impairment. This study aims to evaluate longitudinal changes in cognitive function and metabolic parameters in adolescent patients following sleeve gastrectomy (SG) and to identify independent predictors of neurocognitive improvement.</p><p><strong>Methods: </strong>This prospective study enrolled 40 adolescents with obesity who underwent bariatric surgery, met the surgical criteria, and had a cognitive function score of < 26. Body mass index, cognitive function scores, and metabolic and hormonal parameters were recorded one week prior to surgery and at 1, 3, and 6 months post-surgery.Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Data analysis was performed using simple effects analysis and multiple linear regression.</p><p><strong>Results: </strong>Compared with preoperative levels, significant improvements in BMI, metabolic markers, and hormone levels were observed at all postoperative time points (P < 0.001). Postoperative MoCA total scores, memory scores, and attention scores all showed a sustained upward trend (P < 0.001). Multivariate linear regression analysis revealed that BMI, Homeostatic model assessment of insulin resistance(HOMA-IR), Hcy, and Homocysteine(Hcy) were independent predictors of cognitive function scores. Specifically, lower levels of BMI, HOMA-IR, and Hcy, as well as higher levels of HDL, were significantly associated with higher cognitive scores (P < 0.05).</p><p><strong>Conclusion: </strong>In the short term, SG was effective in reducing the BMI of adolescents with obesity, improving their metabolic and hormonal parameters, and enhancing cognitive function (particularly memory and attention). These findings suggest that SG may provide benefits extending beyond weight reduction.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5420-5429"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Roux-en-Y Gastric Bypass Produces Sustained Uric Acid Reduction and Near-Elimination of Hyperuricemia at 24 Months - A Single-Center Longitudinal Cohort Study.","authors":"Charalampos Lampropoulos, Dimitrios Kehagias, Konstantina Soultana Kitsou, Paraskevi Dedopoulou, Eirini Kehagia, Ioannis Kehagias","doi":"10.1007/s11695-026-08939-0","DOIUrl":"10.1007/s11695-026-08939-0","url":null,"abstract":"<p><strong>Background: </strong>Obesity is a major and well-established risk factor for hyperuricemia and gout. Metabolic and bariatric surgery (MBS) is associated with marked and sustained improvements in metabolic health. The long-term trajectory of serum uric acid (UA) levels after Roux-en-Y gastric bypass (RYGB) is incompletely characterized. In this study, we sought to describe the evolution of serum UA concentrations during the first 24 months after RYGB.</p><p><strong>Methods: </strong>We performed a single-center longitudinal cohort study of adults undergoing RYGB between 2015 and 2023. Serum UA was measured preoperatively (baseline) and at 6, 12, and 24 months postoperatively. Temporal trends in UA were examined using linear mixed effects models. The prevalence of hyperuricemia (UA >7.0 mg/dL in men, UA >6.0 mg/dL in women) was compared across time points using paired McNemar tests. Multivariable regression analyses were conducted to identify independent predictors of UA levels at 24 months.</p><p><strong>Results: </strong>Ninety-four patients were analyzed (mean baseline BMI, 54.1 kg/m2; 31.9% male). Mean serum UA levels decreased from 7.34 mg/dL at baseline to 6.13, 5.13, and 4.71 mg/dL at 6, 12, and 24 months, respectively, which corresponds to a mean reduction of 2.64 mg/dL from baseline to 24 months (p < 0.001). Male sex was consistently associated with higher UA levels at all time points (mean difference, +0.97 mg/dL; p < 0.001) without evidence of a sex-by-time interaction (p = 0.97). The prevalence of hyperuricemia decreased from 57.4% preoperatively to 33.0%, 9.8%, and 2.2% at 6, 12, and 24 months, respectively. At 24 months postoperatively, 96% of subjects with baseline hyperuricemia had achieved normouricemia. In multivariable analyses, higher baseline serum UA (β = 0.176 per mg/dL; p < 0.001) and male sex (β = 0.848; p < 0.001) independently predicted 24-month serum UA concentrations.</p><p><strong>Conclusions: </strong>RYGB was associated with substantial and sustained reductions in serum UA and marked resolution of hyperuricemia during 24 months of follow-up. Higher baseline UA concentrations and male sex were independently associated with higher UA levels at 24 months. Larger prospective studies are warranted to confirm these findings and evaluate their clinical implications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5437-5446"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sleeve Gastrectomy on Obesity Indices, Reproductive Hormones, and Ovarian Reserve Markers: A 12-Month Prospective Study.","authors":"Kyriakos Bananis, Charalampos Voros, Evangelos Menenakos, Georgios Zografos, Georgios Daskalakis, Dimitrios Theodorou","doi":"10.1007/s11695-026-08937-2","DOIUrl":"10.1007/s11695-026-08937-2","url":null,"abstract":"<p><strong>Background: </strong>Severe obesity is associated with hormonal imbalances, hyperandrogenism, and insulin resistance, all of which adversely affect reproductive physiology. Metabolic and bariatric surgery (MBS) produces durable weight loss and metabolic improvement, but its effects on ovarian reserve markers and reproductive hormones in women of reproductive age remain incompletely characterized.</p><p><strong>Objective: </strong>To prospectively evaluate the impact of laparoscopic sleeve gastrectomy on obesity indices, reproductive hormones, ovarian reserve markers, and insulin resistance over 12 months in women with severe obesity.</p><p><strong>Methods: </strong>Thirty-two women with severe obesity (BMI > 40 kg/m²) undergoing laparoscopic sleeve gastrectomy were assessed at three time points: baseline (2-4 weeks before surgery, prior to the standard pre-operative very-low-calorie diet), 6 months, and 12 months post-operatively. Anthropometric, reproductive-hormone (anti-Müllerian hormone [AMH], antral follicle count [AFC], follicle-stimulating hormone [FSH], luteinizing hormone [LH], estradiol, sex hormone-binding globulin [SHBG], total testosterone, calculated free androgen index [FAI]), and metabolic (HOMA-IR) parameters were measured. Non-parametric tests (Wilcoxon signed-rank, Spearman correlation) were applied.</p><p><strong>Results: </strong>BMI decreased from 42.38 ± 1.41 to 25.65 ± 0.34 kg/m² at 12 months (p < 0.001). AMH declined from 3.13 ± 0.17 to 2.24 ± 0.44 ng/mL; AFC fell from 11.22 ± 1.60 to 7.16 ± 1.63 (right ovary) and from 11.09 ± 1.30 to 6.19 ± 0.86 (left ovary). FSH, LH, and estradiol increased; SHBG nearly doubled (36.26 → 63.77 nmol/L); total testosterone decreased markedly (27.76 → 9.34 ng/dL); FAI fell from 2.73 ± 0.85 to 0.53 ± 0.19; HOMA-IR declined from 3.94 ± 0.46 to 1.66 ± 0.56 (all p < 0.001). Spearman correlations among change scores showed inverse associations between ΔSHBG and ΔFAI (ρ = -0.420, p = 0.017), and between ΔHOMA-IR and Δtotal testosterone (ρ = -0.374, p = 0.035).</p><p><strong>Conclusions: </strong>Sleeve gastrectomy was associated with marked improvements in insulin resistance and androgenic profiles, accompanied by progressive increases in SHBG and reductions in FAI, AMH, and AFC over 12 months. Rather than suggesting deterioration of ovarian function, the overall hormonal pattern appears more consistent with normalization of obesity-associated dysregulated folliculogenesis within an improved metabolic environment. While direct reproductive outcomes were not assessed, these findings support the concept that metabolic bariatric surgery may substantially remodel the endocrine milieu linked to ovarian physiology. Larger prospective studies incorporating fertility-related endpoints are required to clarify the reproductive significance of these changes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5255-5264"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency and Association between Adverse Childhood Experiences and Psychiatric Outcomes Among Treatment-seeking Patients with Severe Obesity: a Retrospective Observational Study.","authors":"Mariane Carvalho Cremonesi, Leorides Severo Duarte-Guerra, Denis Pajecki, Marco Aurélio Santo, Francisco Lotufo-Neto, Yuan-Pang Wang","doi":"10.1007/s11695-026-08883-z","DOIUrl":"10.1007/s11695-026-08883-z","url":null,"abstract":"<p><strong>Introduction: </strong>Adverse childhood experiences (ACEs) are well-established risk factors for obesity and psychiatric disorders in adulthood. Despite growing evidence, the association of specific ACE categories with the mental health of patients with severe obesity remains poorly understood. This study aimed to evaluate the frequency of ACEs and the association of ACEs with mental conditions among patients who underwent metabolic bariatric surgery.</p><p><strong>Methods: </strong>A total of 141 were recruited from a specialized bariatric center. ACEs were assessed using the Childhood Experiences section of the Composite International Diagnostic Interview 3.0. Psychiatric disorders (current and lifetime) were evaluated using the Structured Clinical Interview for DSM-5.</p><p><strong>Results: </strong>The sample (83.0% women; mean age 52 years; mean BMI 34.2 kg/m²) showed that 91.5% of patients reported at least one ACE, with maltreatment being the most frequent (81.6%). Among the ACE categories, family maladjustment was associated with the highest number of psychiatric disorders, both in current and lifetime assessments. Specifically, it was significantly associated with bipolar disorder (current: OR = 2.9; lifetime: OR = 3.5), any substance use disorder (current: OR = 4.3; lifetime: OR = 5.3), and any anxiety disorder (current: OR = 2.9; lifetime: OR = 2.3). The number of ACEs was associated with current psychiatric disorders (p = 0.04), where each additional ACE increased the odds of current psychiatric disorders by 7% (OR = 1.1, 95% CI: 1.0-1.1).</p><p><strong>Conclusions: </strong>Patients with severe obesity presented a high frequency of ACEs, which was associated with a later risk of developing psychiatric disorders.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5184-5191"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Cholecystectomy and Gastroesophageal Inflammatory Findings After Sleeve Gastrectomy: Endoscopic and Metabolic Evaluation.","authors":"Gabriel Guerra Cordeiro, Vinícius Vasconcelos do Amaral, Luiz Alberto Reis Mattos Júnior, Flávio Kreimer, José Guido Correia de Araújo Júnior, Álvaro Antônio Bandeira Ferraz","doi":"10.1007/s11695-026-08947-0","DOIUrl":"10.1007/s11695-026-08947-0","url":null,"abstract":"<p><strong>Introduction: </strong>Sleeve gastrectomy (SG) is associated with the development or worsening of gastroesophageal reflux disease (GERD). Cholecystectomy following SG - the standard treatment for cholelithiasis resulting from rapid weight loss - may influence GERD pathophysiology by enhancing enterohepatic bile circulation and increasing alkaline reflux.</p><p><strong>Objective: </strong>To investigate the longitudinal development of endoscopic and histologic esophageal and gastric mucosal findings, alongside systemic metabolic profiles, across defined pre- and post-cholecystectomy intervals in individuals previously managed with SG.</p><p><strong>Methods: </strong>A longitudinal, retrospective, observational cohort study was conducted with 133 patients who underwent cholecystectomy after SG between 2009 and 2017. Endoscopic findings were analyzed at three time points: pre-SG, pre-cholecystectomy, and post-cholecystectomy.</p><p><strong>Results: </strong>Compared with the pre-sleeve gastrectomy assessment, moderate esophagitis increased from 3.0% to 12.2% and severe esophagitis from 0.8% to 2.7% at the post-cholecystectomy evaluation. In contrast, the direct comparison between the pre- and post-cholecystectomy assessments demonstrated a significant increase in gastric inflammatory findings, particularly moderate gastritis. Gastritis prevalence increased from 33.9% to 51.4% (p < 0.05), with moderate to severe cases rising from 11.9% to 23.0% (p < 0.05). BMI and metabolic parameters (HbA1c, insulin, fasting glucose, cholesterol, triglycerides, uric acid, and C-peptide) improved significantly (p < 0.001).</p><p><strong>Conclusion: </strong>Cholecystectomy following sleeve gastrectomy was associated with an increased prevalence and severity of gastritis and a progressive trend in esophagitis over time, without compromising the long-term metabolic benefits of SG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5459-5466"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645868/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tranexamic Acid Administration in Laparoscopic Sleeve Gastrectomy.","authors":"Magdy H Eldegwy, Hany O Ragab, Mohammed A Taha Alafifi, Ismail A Elzoughari, Hosni Ali Salem, Waleed Hamdy Shokr, Talal Saad Almukhlifi, Hatem Mahmoud Nasr Elkenany, Mohamed Hegab, Mohamed Ali Mahmoud, Ayman Ahmed Abdeltawab Ebrahim, Elsayed A Awad, Abdallah Elabd Hassan, Azza Mahrous Shaffik","doi":"10.1007/s11695-026-08909-6","DOIUrl":"10.1007/s11695-026-08909-6","url":null,"abstract":"<p><strong>Background and aim: </strong>Perioperative bleeding remains one of the most frequent early complications of laparoscopic sleeve gastrectomy (LSG). The present work aimed to provide a thorough and updated systematic review and meta-analysis of the published studies on the use of tranexamic acid (TXA) in LSG.</p><p><strong>Methods: </strong>The present study was conducted according to the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) guidelines. A systematic literature search was conducted in PubMed, Scopus, and Web of Science.</p><p><strong>Results: </strong>The present study analyzed 9 studies. They included 1665 patients. TXA was administered to 842 patients while 823 patients received no intervention or placebo. Pooled analysis revealed significantly shorter operative duration [mean difference (95% CI): -4.56 (-7.36, -1.76), p = 0.001], shorter length of hospital stay [mean difference (95% CI): -0.12 (-0.16, -0.08), p<0.00001] and lower reduction of preoperative hemoglobin levels in the TXA arm [mean difference (95% CI): -0.2 (-0.38, -0.02), p = 0.03]. No significant differences were found between the interventional arms regarding number of used intraoperative hemostatic clips [mean difference (95% CI): -0.2 (-0.93, 0.53), p = 0.59], number of patients requiring blood transfusion [RD (95% CI): -0.01 (-0.02, 0.0), p = 0.08] or number of patients requiring reoperation for bleeding [RD (95% CI): -0.01 (-0.03, 0.0), p = 0.12]. No thromboembolic events were reported.</p><p><strong>Conclusions: </strong>The present study suggests that, based on the currently available evidence, intraoperative administration of TXA is associated with lower reduction of preoperative hemoglobin levels in patients undergoing LSG, which may contribute to shorter operative duration and reduced length of hospital stay.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5131-5144"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148912104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elastic Intracorporeal Retraction in Laparoscopic Bariatric Surgery: Performance, Safety, and Multi-Organ Applications.","authors":"Youssef Andraos, Safwan Taha, Riwa Deghaim","doi":"10.1007/s11695-026-08920-x","DOIUrl":"10.1007/s11695-026-08920-x","url":null,"abstract":"<p><strong>Background: </strong>Effective organ retraction is essential for safe minimally invasive bariatric surgery. Traditional retraction techniques have notable limitations: rigid external retractors require subxiphoid incisions and are associated with hepatic trauma and biochemical liver injury, while handheld retractors require additional trocars, increasing complications and operative time. The Elastic Intracorporeal Retractor (EICR) was developed as a trocar-free, hands-free multi-organ retraction system.</p><p><strong>Objectives: </strong>To evaluate the intraoperative performance, technical feasibility, and safety of the EICR in consecutive laparoscopic bariatric procedures.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>This retrospective study included 96 consecutive procedures performed between January 2022 and January 2025 by a single surgeon. The EICR (XNY Medical) was deployed through a standard 10-mm trocar. Primary outcomes included technical performance (first-attempt deployment, insertion time, repositioning). Secondary outcomes assessed safety through intraoperative events and 30-day outcomes. Independent blinded video review by an external surgeon evaluated 40 consecutive cases.</p><p><strong>Results: </strong>The EICR achieved first-attempt deployment in 99% of cases, with median insertion time of 95 s (IQR 75-115). Repositioning occurred in 10.4%; no additional retraction trocars were required in any case. The device was used for liver retraction in 89.6% of cases, with retraction of a structure other than the liver in 8 of 96 patients (8.3%): the oesophagus in 7 and the greater omentum in 1. Minor retraction-related complications occurred in 5.2% (four serosal tears <5 mm, one hook disconnection), all managed conservatively. Liver function tests in complication cases were within normal limits; systematic cohort-wide testing was not performed. No major complications, conversions, or reoperations occurred. Independent blinded review demonstrated complete concordance with documented outcomes.</p><p><strong>Conclusions: </strong>Across 96 consecutive procedures with independent blinded video validation, the EICR provided reliable, reproducible organ retraction with a rapid deployment time, an acceptable intraoperative safety profile, and no requirement for additional retraction trocars. Retraction was also achieved beyond the liver in 8 of 96 patients (oesophagus, 7; greater omentum, 1). As an uncontrolled single-surgeon series, this study demonstrates feasibility; comparative effectiveness against existing retraction methods now warrants prospective controlled evaluation.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5377-5387"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Removal of Non-Eroding Gastric Bands Post Silastic Ring Vertical Gastroplasty Using Lumen-Apposing Metal Stents-a Case Series.","authors":"Amir Luchtenstein, Relly Reicher, Shai Meron Eldar, Adam Abu-Abeid, Danit Dyan, Sigal Fishman, Mati Shnell","doi":"10.1007/s11695-026-08902-z","DOIUrl":"10.1007/s11695-026-08902-z","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic removal of gastric bands after silastic ring vertical gastroplasty (SRVG) has emerged as a viable alternative to surgical revision. Most endoscopic removals require prior spontaneous band erosion into the gastric lumen. For non-eroded bands, self-expanding metal/plastic stents (SEMS/SEPS) have been used to induce erosion but carry risk of migration. We hypothesized that lumen-apposing metal stents (LAMS), with their antimigration flanged design, could safely induce controlled erosion with fewer complications. This study evaluates the feasibility and short-term outcomes of LAMS-assisted band removal.</p><p><strong>Methods: </strong>We retrospectively analyzed 10 patients with non-eroding silastic bands and obstructive symptoms (emesis, dysphagia, or regurgitation) who underwent endoscopic band removal using LAMS. LAMS placement was performed to induce controlled erosion and migration of the band into the gastric lumen. A second endoscopy was scheduled at 1-3 months to remove the stent and band. Clinical success was defined as successful band removal without periprocedural complications.</p><p><strong>Results: </strong>All 10 patients underwent successful endoscopic band removal without periprocedural complications and were discharged within 24 h. Four patients (40%) required additional endoscopic balloon dilatations for gastric stenosis. Emesis, reported preoperatively in all 10 patients (100%), was resolved in 8 patients (80%) following the procedure. Mean Eckardt symptom score improved from 4.3 ± 1.8 to 1.4 ± 2.2.</p><p><strong>Conclusion: </strong>LAMS-induced erosion is a feasible and technically successful endoscopic technique for removal of non-eroding gastric bands in SRVG patients, with a favorable short-term complication profile.</p><p><strong>Key points: </strong>• LAMS achieved 100% technical success for non-eroding band removal (n = 10). • No periprocedural complications; all patients discharged within 24 h. • Emesis resolved in 80%; mean Eckardt score improved from 4.3 to 1.4. • LAMS offers a minimally invasive alternative to surgical band revision.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"5037-5042"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}