Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-05-06DOI: 10.1007/s11695-025-07901-w
Pierre Platevoet, Antoine Mariani, Lionel Rebibo, Gilles Manceau, Mehdi Karoui
{"title":"Laparoscopic Upper Polar Esophagogastrectomy with Gastroplasty Using Gastric Remnant After Roux-en-Y Gastric Bypass for Recurrent Gastroesophageal Junction Adenocarcinoma.","authors":"Pierre Platevoet, Antoine Mariani, Lionel Rebibo, Gilles Manceau, Mehdi Karoui","doi":"10.1007/s11695-025-07901-w","DOIUrl":"10.1007/s11695-025-07901-w","url":null,"abstract":"<p><p>Roux-en-Y gastric bypass is a commonly performed procedure for the treatment of severe obesity. Oncological surgery for patients who have had a prior Roux-en-Y gastric bypass with esophagogastric cancer poses technical challenges, mainly because of the altered anatomy. We present in this video an upper polar esophagogastrectomy with gastroplasty on a gastric remnant and the reversal of Roux-en-Y gastric bypass performed in a 55-year-old woman with an anastomotic recurrence of an adenocarcinoma of the gastroesophageal junction. As far as we know, there is no report about the surgical management of an anastomotic recurrence of an adenocarcinoma of the gastroesophageal junction in a patient with altered anatomy due to RYGB and upper polar gastrectomy.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2395-2398"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013758","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-04-26DOI: 10.1007/s11695-025-07875-9
Mathias Schmid, Patrick Folie, Rene Warschkow, Thomas Steffen
{"title":"Long-Term Results of Linear Versus Circular Stapled Gastrojejunostomy in Gastric Bypass Surgery: A Propensity Score-Adjusted Analysis of Weight Loss and Morbidity.","authors":"Mathias Schmid, Patrick Folie, Rene Warschkow, Thomas Steffen","doi":"10.1007/s11695-025-07875-9","DOIUrl":"10.1007/s11695-025-07875-9","url":null,"abstract":"<p><strong>Background: </strong>Different techniques are used to create a gastrojejunal anastomosis (GJ) in laparoscopic Roux-en-Y gastric bypass (LRYGB). This study compares long-term weight loss and technique-related morbidity between circular (CSA) GJ and linear (LSA) stapled GJ.</p><p><strong>Methods: </strong>The clinical data of LRYGB patients prospectively registered in a database were retrospectively analyzed. The primary endpoints were long-term excess weight loss (EWL) and excess BMI loss (EBL). The risk factors were adjusted via propensity score matching (PSM), and the long-term morbidity rates of the procedures were compared as time-to-event-data using hazard ratios (HR).</p><p><strong>Results: </strong>Two hundred forty-three patients underwent surgery between 2012 and 2014 (CSA n = 109; LSA n = 134). No significant differences in weight development were shown during 6 years postoperatively between CSA and LSA. A mixed effects regression analysis before and after PSM revealed that CSA performed better than LSA after 6 years (potentially biased by low follow-up rates for this period). CSA was associated with higher overall morbidity (LSA 26.1% vs. CSA 38.8%, HR = 1.58, p = 0.048), incisional hernia (LSA 0.7% vs. CSA 6.4%, HR = 10.0, p = 0.006), and GJ stenosis rates (LSA 0% vs. CSA 17.4%, p < 0.001). LSA was associated with marginal ulcers (LSA 8.2% vs. CSA 0.9%, HR = 5.5, p = 0.012).</p><p><strong>Conclusions: </strong>Marginal ulcers have been linked to LSA, while CSA has been associated with higher rates of overall morbidity, stenosis of the GJ, and incisional hernia. No difference terms of weight loss were observed between the CSA and LSA groups during the initial six postoperative years. After 6 years, CSA may offer benefits in terms of sustained weight loss; however, the clinical relevance of these differences appears minimal.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2132-2141"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014852","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-05-09DOI: 10.1007/s11695-025-07909-2
Luc Groshaeny, Emmanuel Gomez, Simon Valentin, Pierre Thore, Marine Fauny, Nicolas Carpentier, Claire Nomine-Criqui, Laurent Brunaud, Didier Quilliot, Francois Chabot, Ari Chaouat, Bruno Ribeiro Baptista
{"title":"Comparison of Home Sleep Polygraphy or Laboratory Polysomnography for the Diagnosis of OSA Before Bariatric Surgery.","authors":"Luc Groshaeny, Emmanuel Gomez, Simon Valentin, Pierre Thore, Marine Fauny, Nicolas Carpentier, Claire Nomine-Criqui, Laurent Brunaud, Didier Quilliot, Francois Chabot, Ari Chaouat, Bruno Ribeiro Baptista","doi":"10.1007/s11695-025-07909-2","DOIUrl":"10.1007/s11695-025-07909-2","url":null,"abstract":"<p><strong>Background: </strong>In-laboratory polysomnography (PSG) is considered the gold standard for diagnosing obstructive sleep apnea (OSA). Our study aimed to compare whether home polygraphy (PG) could provide comparable diagnostic accuracy to PSG before bariatric surgery in a real-life cohort and to determine whether home PG is associated with a higher incidence of complications.</p><p><strong>Methods: </strong>In a retrospective study, we compared 400 patients who performed home PG or laboratory PSG between January 2017 and March 2020. All patients included had to be incident cases and had to have undergone bariatric surgery after the sleep test.</p><p><strong>Results: </strong>Among the participants, 215 underwent PSG, while 185 underwent PG. Demographic characteristics such as age, sex, BMI, and Epworth sleepiness score were similar between groups. The apnea-hypopnea index was significantly lower in the PG group (21 ± 20 events/h) compared to the PSG group (29 ± 28 events/h) (p < 0.001). The proportion of patients treated with positive airway pressure was comparable between the two groups. Following bariatric surgery, the duration of hospitalization and the incidence of postoperative complications did not differ significantly between the two groups.</p><p><strong>Conclusion: </strong>Our findings suggest that before bariatric surgery, home PG could identify patients requiring positive airway pressure as equivalent to in-laboratory PSG, without increasing postoperative complications.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2234-2239"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030904","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-05-08DOI: 10.1007/s11695-025-07904-7
Ahmed Abokhozima, Hassan El-Masry, Ahmed Abo Elmagd, Mohammed Alokl
{"title":"Innovative Left Liver Mobilization for Hiatal Exposure: Advancing Bariatric Surgery Despite Unresolved Safety Questions.","authors":"Ahmed Abokhozima, Hassan El-Masry, Ahmed Abo Elmagd, Mohammed Alokl","doi":"10.1007/s11695-025-07904-7","DOIUrl":"10.1007/s11695-025-07904-7","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2019-2020"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031044","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-05-16DOI: 10.1007/s11695-025-07920-7
Tong Mu, Kejiang Chen, Yi Xu, Yonggang Hao, Dan Liu, Ke Wei
{"title":"Comparison Between Erector Spinae Plane Block at T9 Level and Transversus Abdominis Plane Block for Postoperative Analgesia and Recovery in Patients with Obesity Undergoing Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial.","authors":"Tong Mu, Kejiang Chen, Yi Xu, Yonggang Hao, Dan Liu, Ke Wei","doi":"10.1007/s11695-025-07920-7","DOIUrl":"10.1007/s11695-025-07920-7","url":null,"abstract":"<p><strong>Introduction: </strong>Effective postoperative analgesia is essential for recovery after bariatric surgery. This study examines whether T9 erector spinae plane (ESP) block provides better analgesia and recovery than subcostal transversus abdominis plane (TAP) block in patients with obesity undergoing laparoscopic sleeve gastrectomy (LSG).</p><p><strong>Methods: </strong>Patients undergoing LSG were randomized to receive either ESP or TAP blocks. The primary outcome was pain intensity measured by the Numeric Rating Scale (NRS). Secondary outcomes included sensory blockade levels, opioid consumption (morphine equivalents), need for rescue analgesia, and recovery milestones.</p><p><strong>Results: </strong>Among 168 patients, median age was 29.0 years (ESP) vs 31.0 years (TAP) (p = 0.135), with most being female (67.9% ESP, 65.5% TAP) (p = 0.743). Median BMI was 36.7 kg/m<sup>2</sup> (ESP) vs 37.1 kg/m<sup>2</sup> (TAP) (p = 0.819). Patients receiving ESP blocks consistently reported lower NRS scores postoperatively (p = 0.002 and p < 0.001). Sensory blockade in the ESP group was more consistent (84.5% at T6-T12), whereas the TAP group exhibited greater variability (p < 0.001). Opioid consumption within 48 h was lower in the ESP group (median reduction of 8 mg) (p < 0.001). Moreover, ESP group patients needed less rescue analgesia (p = 0.001) and demonstrated faster functional recovery (p < 0.001).</p><p><strong>Conclusions: </strong>For patients with obesity undergoing LSG, ultrasound-guided ESP block at T9 enhances postoperative analgesia and accelerates recovery compared to subcostal TAP block. While the difference in NRS scores was modest, ESP's ability to reduce opioid use and promote faster recovery highlights its clinical advantage.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2249-2263"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079333","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-04-23DOI: 10.1007/s11695-025-07880-y
Imed Ben Amor, Panagiotis Lainas, Fahad Alghareeb, Sarah Ben Amor, Rayan Rassouli, Patrick Baqué
{"title":"Fully Robotic Sleeve Gastrectomy Using Complete Gastric Staple Line Bioabsorbable Reinforcement: How I Do It (a Video).","authors":"Imed Ben Amor, Panagiotis Lainas, Fahad Alghareeb, Sarah Ben Amor, Rayan Rassouli, Patrick Baqué","doi":"10.1007/s11695-025-07880-y","DOIUrl":"10.1007/s11695-025-07880-y","url":null,"abstract":"<p><p>Robotic sleeve gastrectomy (RSG) is gaining place among surgeons. In our initial RSG practice, we noticed that gastric staple line intraoperative bleeding is more frequent and more important compared to the conventional laparoscopic approach. Any technique that could reduce the likelihood of intraoperative bleeding in RSG would be of tremendous benefit. The present video report is a detailed description of a fully RSG using complete gastric staple line bioabsorbable reinforcement, minimizing intraoperative bleeding. We present the case of a 32-year-old female patient with severe obesity (weight = 132 kg; BMI = 46.8 kg/m2) that underwent fully RSG in our department. RSG technique is thoroughly described, highlighting several important aspects of RSG, including (i) patient positioning to optimize access and ergonomics; (ii) the use of a Nathanson liver retractor, avoiding interference with robotic arms; (iii) trocar placement strategy; (iv) intraoperative selection of stapler reloads; and (v) the use of a bioabsorbable reinforcement (Seamguard®, Gore) for staple line reinforcement and bleeding minimization. Operative time was 180 min, and, blood loss was minimal (< 10 ml). The patient was discharged on postoperative day 1. Postoperative recovery was uneventful, without bleeding, gastric leak, or other complications. Only simple oral analgesics were required postoperatively. At 1-month follow-up visit, the patient had lost 10 kg and reported significant improvement in overall health. Complete gastric staple line bioabsorbable reinforcement seems to decrease intraoperative bleeding when the robotic approach is used for sleeve gastrectomy. Prospective randomized studies are needed to validate this approach as gold standard practice for RSG.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2384-2386"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973005","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-04-21DOI: 10.1007/s11695-025-07862-0
Sarfaraz Jalil Baig, Aishwarya Varma
{"title":"Surgeons Performing Sleeve Gastrectomy Fret too much about the Antral Mill!","authors":"Sarfaraz Jalil Baig, Aishwarya Varma","doi":"10.1007/s11695-025-07862-0","DOIUrl":"10.1007/s11695-025-07862-0","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2007-2008"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975138","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-05-13DOI: 10.1007/s11695-025-07923-4
Mohamed H Zidan, Nour Zayed, Mohamed Hany
{"title":"Are We Adopting New Technologies in MBS to Serve the Patients or Because They Fascinate the Surgeon?","authors":"Mohamed H Zidan, Nour Zayed, Mohamed Hany","doi":"10.1007/s11695-025-07923-4","DOIUrl":"10.1007/s11695-025-07923-4","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2030-2034"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032743","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}
Obesity SurgeryPub Date : 2025-06-01Epub Date: 2025-04-17DOI: 10.1007/s11695-025-07844-2
Mohamed Hany, Anwar Ashraf Abouelnasr, Muhammad Gaballah, Ahmed Ragab, Dina Mohamed Hafez, Bart Torensma
{"title":"Gastrocolic Fistula Due to Staple Line Leak Following Metabolic Bariatric Surgery: A Systematic Review.","authors":"Mohamed Hany, Anwar Ashraf Abouelnasr, Muhammad Gaballah, Ahmed Ragab, Dina Mohamed Hafez, Bart Torensma","doi":"10.1007/s11695-025-07844-2","DOIUrl":"10.1007/s11695-025-07844-2","url":null,"abstract":"<p><p>Gastrocolic fistula (GCF) is a rare but serious complication following metabolic bariatric surgery (MBS), primarily caused by leaks from the staple line or anastomotic sites. This systematic review aims to comprehensively analyze the diagnosis and management strategies for GCF following MBS. The Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, Web of Science, and EMBASE were searched until March 2024. Studies were independently screened and extracted using the PRISMA checklist. This systematic review included 16 studies (13 case reports and three retrospective cohort studies). GCF was most prevalent in laparoscopic sleeve gastrectomy (LSG), accounting for 81.2% of the studies. The transverse colon was the most common site of occurrence. Exploratory laparoscopy was utilized as the final treatment or rescue surgery in 85.7% of GCF case report studies, with all patients successfully healed following these interventions. The time from diagnosis to closure of the GCF varied significantly: in acute studies, closure occurred between 14 and 61 days, while in chronic studies, it ranged from 1 to 12 months. This systematic review concludes that surgical intervention should be recommended for managing GCF following specific staple line leaks in LSG. Most GCF studies occurred more than 6 months post-surgery, indicating a late complication. Computed tomography (CT) was the most frequently used diagnostic tool. Although over-the-scope clips (OTSC) and stents were employed, their efficacy as primary treatments remain questionable due to limited and inconsistent study outcomes.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2277-2295"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023390","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}