Obesity Surgery最新文献

{"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}

{"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}

{"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}

{"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}

{"title":"Post-Bariatric Anemia Recovery: Addressing Surgical Imbalance and Inflammation.","authors":"Yutao Tao, Ziyang Bao","doi":"10.1007/s11695-025-07897-3","DOIUrl":"10.1007/s11695-025-07897-3","url":null,"abstract":"","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2015-2016"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143973008","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":"Closure of Mesenteric Defects During Roux-en-Y Gastric Bypass Using Ifabond® Surgical Glue.","authors":"Antoine Sina, Christian Mouawad","doi":"10.1007/s11695-025-07873-x","DOIUrl":"10.1007/s11695-025-07873-x","url":null,"abstract":"<p><strong>Purpose: </strong>There is no consensus regarding the optimal technique for mesenteric defects' closure after Roux-en-Y gastric bypass (RYGB). In our article, we will describe our experience with mesenteric defect closure during RYGB using n-Hexyl-Cyanoacrylate surgical glue.</p><p><strong>Material and methods: </strong>We conducted a prospective study based on a non-randomized, monocentric, single-operator data collection between January 2018 and January 2022. Included patients were undergoing first and second intention RYGB for morbid obesity. In total, 357 patients underwent RYGB among whom 202 patients (56.5%) underwent mesenteric defect closure with a non-absorbable barbed running suture, and 155 patients (43.5%) underwent closure with n-Hexyl-Cyanoacrylate surgical glue.</p><p><strong>Results: </strong>After a mean follow-up duration of 28 months, there was no surgical revision in the surgical glue group. As for the group who received a running suture, two patients (1%) underwent laparoscopic surgical revision for an internal hernia.</p><p><strong>Conclusion: </strong>Defect closure during RYGB using n-Hexyl-Cyanoacrylate surgical glue seems to be a fast, effective, and safe technique which avoids the risk of mesenteric trauma.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2274-2276"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975190","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":"Safety of Same-Day Discharge Bariatric Surgery: A Comprehensive Analysis of 457 Cases Across Multiple Procedure Types.","authors":"Sunil Sharma, Amit Surve, Daniel Cottam, Ashley Wooley, Jaycee Christensen, Smita Sharma, Tristan Patel","doi":"10.1007/s11695-025-07874-w","DOIUrl":"10.1007/s11695-025-07874-w","url":null,"abstract":"<p><strong>Background: </strong>Outpatient bariatric surgery offers reduced hospital stays and healthcare costs, with promising safety outcomes. This study analyzes the short-term results of stand-alone primary and revision bariatric surgeries, alongside concomitant foregut and abdominal surgeries associated with bariatric procedures, to assess their safety and efficacy in an outpatient setting at a free-standing ambulatory center.</p><p><strong>Methods: </strong>A retrospective study was conducted on 457 same-day discharge (SDD) bariatric cases performed by a single surgeon at a free-standing ambulatory center between January 2021 and July 2024. The procedures included sleeve gastrectomy (SG), duodenal switch (DS), adjustable gastric band (AGB) removal, and Roux-en-Y gastric bypass (RYGB). Concomitant foregut and abdominal surgeries associated with bariatric procedures, such as hiatal hernia repair (HHR), cholecystectomy, fundoplication, and ventral hernia repair, were performed when clinically indicated.</p><p><strong>Results: </strong>Of the 457 cases, 97.8% were primary surgeries, and 2.1% were revisions. Stand-alone procedures accounted for 39.3%, and 60.6% were concomitant. SG constituted 74.8% of cases, followed by HHR (16.1%), DS (5.4%), AGB removal (2.6%), and RYGB (.8%). The mean operative time was 79.9 ± 24.3 min, with a mean length of stay of 3 h 52 min (± 1:10). The 30-day complication rate was 2.1%, with Clavien-Dindo grade IIIb complications in .8% of patients. Patient satisfaction was high, with a mean score of 9.8.</p><p><strong>Conclusions: </strong>Outpatient bariatric surgeries demonstrated strong safety with minimal complications, underscoring their viability in carefully selected patients. Staged approaches for complex cases further optimized outcomes, making outpatient settings a robust option for a wide range of bariatric procedures.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2101-2110"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029437","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":"Hair Loss and Metabolic and Bariatric Surgery: An Updated Systematic Review and Meta-analysis.","authors":"Nima Taghizadeh, Hussein Salhab, Ali Alirezaei, Khosrow Najjari, Wah Yang, Raziyhe Abedi-Kichi, Ali Esparham, Shahab Shahabi Shahmiri","doi":"10.1007/s11695-025-07903-8","DOIUrl":"10.1007/s11695-025-07903-8","url":null,"abstract":"<p><p>The current updated systematic review and meta-analysis aims to investigate the rate of hair loss after metabolic and bariatric surgery (MBS). A systematic search was done on PubMed, Scopus, Google Scholar, and Web of Science. The primary outcome of this study was to investigate the incidence of hair loss following MBS. In this meta-analysis of 41 articles with 7044 patients, our results showed that the incidence of hair loss after MBS was 47%. In addition, Roux-en-Y gastric bypass had a significantly higher rate of hair loss than sleeve gastrectomy (OR = 1.91). On the other hand, Roux-en-Y gastric bypass had a significantly lower rate of hair loss compared to duodenal switch (OR = 0.41). Hair loss is a common complication after MBS, especially after the duodenal switch and Roux-en-Y gastric bypass.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2370-2380"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094481","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":"Risk Factors for Type 2 Diabetes Mellitus Relapse in More Than 5-Year Follow-up After Sleeve Gastrectomy with Transit Bipartition.","authors":"Cüneyt Kırkıl, Mesut Yur, İlayda Aydın, Ahmet Bozdağ, Ahmet Aslan, Mehmet Fatih Ebiloğlu","doi":"10.1007/s11695-025-07906-5","DOIUrl":"10.1007/s11695-025-07906-5","url":null,"abstract":"<p><strong>Background: </strong>In some patients who achieved complete remission (CR) of type 2 diabetes mellitus (T2DM) after sleeve gastrectomy with transit bipartition (TB), T2DM relapses after a while. ABCD scoring predicts the likelihood of remission following TB. However, the factors affecting T2DM relapse are unknown.</p><p><strong>Methods: </strong>The data of patients with CR after TB who were followed for more than 5 years was analyzed retrospectively.</p><p><strong>Results: </strong>The median follow-up of 56 patients, 29 of whom were female (51.8%), was 71 months (range: 61 to 101). Eleven of 56 patients (19.6%) had relapse in T2DM. Patients with an ABCD score less than 4 had a significantly higher rate of relapse. Its sensitivity and specificity rates were 90.9% and 93.3%, respectively. Preoperative C-peptide level (OR 0.032 [CI 0.003-0.295], p = 0.002), LDL-cholesterol level (OR 1.025 [CI 1.005-1.045], p = 0.013), duration of T2DM (OR 1.553 [1.216-1.983], p < 0.001), ABCD score (OR 0.047 [0.006-0.361], p = 0.003), and FIB-4 index (OR 6.073 [1.496-24.656], p = 0.012) were risk factors.</p><p><strong>Conclusions: </strong>Patients with longer durations of T2DM, higher LDL-cholesterol levels, lower C-peptide levels and ABCD scores, and worse liver fibrosis are at a higher risk of relapse after achieving initial CR of T2DM with TB.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2227-2233"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984511","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":"First-in-Human Linear Magnetic Jejuno-Ileal Bipartition: Preliminary Results with Incisionless, Sutureless, Swallowable Technique.","authors":"Michel Gagner, Martin Fried, David Michalsky, Karen Dolezalova, Petra Sramkova, Jan Brezina, Dasa Baliarova, Lucie Hlavata, Michal Novak, Jaroslav Bartos, Sarka Mullerova","doi":"10.1007/s11695-025-07861-1","DOIUrl":"10.1007/s11695-025-07861-1","url":null,"abstract":"<p><strong>Background: </strong>Minimally invasive surgery may be further advanced with the novel biofragmentable magnetic anastomosis compression system. Two magnets may be swallowed, or placed by flexible endoscopy, in a side-to-side magnetic jejuno-ileostomy (MagJI) bipartition for weight and type 2 diabetes (T2D) reduction. MagJI markedly reduces the major complications of enterotomy, stapling/suturing, and retained foreign materials.</p><p><strong>Methods: </strong>This was a prospective first-in-human investigation of feasibility, safety, and preliminary efficacy in adults with body mass index (BMI, kg/m²) ≥ 30.0- ≤ 40.0. After serial introduction via swallowing or endoscopy, linear magnets were laparoscopically guided to the distal ileum and proximal jejunum where they were aligned. Magnets fused over 7-21 days forming jejuno-ileostomy.</p><p><strong>Primary endpoints: </strong>feasibility and severe adverse event (SAEs) incidence (Clavien-Dindo grade); secondary endpoints: weight, T2D reduction.</p><p><strong>Results: </strong>Between 3-1 - 2024 and 6-30 - 2024, nine patients (mean BMI 37.3 ± 1.1) with T2D (all on T2D medications; mean HbA1_C 7.1 ± 0.2%, glucose 144.8 ± 14.3 mg/dL) underwent MagJI. Mean procedure time: both magnets swallowed, 86.7 ± 6.3 min; one magnet swallowed with second delivered endoscopically, 113.3 ± 17.0 min. Ninety-day feasibility confirmed in 100.0%: 0.0% bleeding, leakage, infection, mortality. Most AEs grade I-II; no SAEs. At 6-month radiologic confirmation, all anastomoses were patent. Excess weight loss 17.5 ± 2.8 kg; mean BMI reduction 2.2 ± 0.3, HbA1_C 6.1 ± 0.1% (p < 0.01), glucose 115.5 ± 6.5 mg/dL (p = 0.19); 83.0% dropped below 6.5% HbA1_C and had markedly reduced anti-T2D medications.</p><p><strong>Conclusions: </strong>The swallowable, biofragmentable magnetic anastomosis system appeared to be feasible and safe in achieving incisionless, sutureless jejuno-ileostomy. The first-in-human MagJI procedure may offer minimally complicated anastomosis creation and moderate MBS weight loss and T2D reduction.</p>","PeriodicalId":19460,"journal":{"name":"Obesity Surgery","volume":" ","pages":"2067-2080"},"PeriodicalIF":2.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026637","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}