Journal of Bariatric Surgery最新文献

{"title":"A Delphi Consensus on Surgical Technique of Roux-en-Y Gastric Bypass: An Obesity and Metabolic Surgery Society of India Initiative","authors":"V. Bindal, Dhananjay Pandey, R. Wadhawan, A. Bhasker, Ramen Goel, K. Kular, Sumeet Shah, P. Raj, M. Khaitan, M. Narwaria, P. Chowbey, S. Dhorepatil, R. Khullar, Lashmi Kona Kumari, Atul Peters, Deep Goel, M. Baijal, Shashank Shah, Sandeep Aggarwal, S. Ugale, R. Bhojwani, Sanjay Patolia, N. Dukkipati, Shailesh Gupta, Shahiq Ahmed","doi":"10.4103/jbs.jbs_4_24","DOIUrl":"https://doi.org/10.4103/jbs.jbs_4_24","url":null,"abstract":"\u0000 \u0000 \u0000 Roux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric surgical procedure. However, its complexity has led to various technical adaptations being practiced globally, including in India. Recognizing the need for uniformity in such a crucial procedure, the Obesity Surgery Society of India (OSSI) took the initiative of doing a Delphi consensus on the technique of RYGB.\u0000 \u0000 \u0000 \u0000 A panel of 17 experts, chosen from OSSI members, was formed based on their extensive experience with RYGB, years of practice, the proportion of RYGB in their practice, and their academic contributions and recommendations from the executive committee. A questionnaire comprising 40 statements regarding the key steps of the procedure was shared with the selected experts through email. Consensus was deemed to be reached when the statements received scores exceeding 70%.\u0000 \u0000 \u0000 \u0000 After three rounds of surveys, consensus was reached on 34 statements. Following the first round, statements without consensus underwent reformulation and were redistributed along with pertinent literature. Despite these efforts, six statements remained unresolved by the end of the third round, indicating areas where expert consensus could not be achieved.\u0000 \u0000 \u0000 \u0000 This Delphi consensus gives a snapshot in the practices of experts doing RYGB in India. It details the various intricacies and technical aspects of the procedure.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"5 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141927809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laparoscopic Gastrogastrostomy – An Alternative Procedure for Stenosis after Sleeve Gastrectomy","authors":"Melanie Mercado, Sam Alhayo, Michael Talbot","doi":"10.4103/jbs.jbs_5_24","DOIUrl":"https://doi.org/10.4103/jbs.jbs_5_24","url":null,"abstract":"\u0000 \u0000 \u0000 Reflux symptoms associated with stenosis after laparoscopic sleeve gastrectomy can occur secondary to anatomical abnormality including mechanical stenosis and axial deviation, commonly occurring mid-sleeve. Treatment options include endoscopic intervention, including dilatation, stenting, myotomy, and surgical revision, with Roux-en-Y gastric bypass (RYGB) being preferred by many. In this case series, we report six patients who have undergone laparoscopic gastrogastrostomy (GG) for gastric stenosis and propose this as a possible surgical alternative for appropriately selected patients with symptomatic angularis stenosis.\u0000 \u0000 \u0000 \u0000 Medical records for six patients who underwent laparoscopic GG for treatment of persistent reflux symptoms due to angularis stenosis were reviewed. All patients were preoperatively investigated with endoscopy and abdominal three-dimensional computed tomography. Hiatal hernia and esophageal dilation were excluded. After further consultation, patients proceeded to laparoscopic GG.\u0000 \u0000 \u0000 \u0000 Complete resolution of symptoms was reported in three of six patients, with Visick score 1, while the other three reported significantly improved symptoms. Postoperative body mass index remained similar to prerevision baseline. There were no postoperative complications.\u0000 \u0000 \u0000 \u0000 Revision to RYGB is effective for stenosis and reflux but can be challenging with the potential for long-term nutritional deficiencies and surgical complications. For patients with angularis stenosis, laparoscopic GG is a simpler revisional procedure that has shown adequate initial outcomes with no short or anticipated long-term complications in this case series. Patients with persisting symptoms could undergo subsequent gastric bypass if needed.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"59 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141102323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Effective is Transversus Abdominis Plane Block in Reducing Pain and Opioid Needs Following Bariatric Surgery?","authors":"Ciara Lopez, Dennis Smith, Cynthia Buffington","doi":"10.4103/jbs.jbs_2_24","DOIUrl":"https://doi.org/10.4103/jbs.jbs_2_24","url":null,"abstract":"\u0000 \u0000 \u0000 Several studies have found that ultrasound-guided transversus abdominis plane (TAP) block is useful for pain management with bariatric surgery. In this study, we have examined perioperative pain management and opioid needs of totally robotic (TR) Roux-en-Y gastric bypass and sleeve gastrectomy patients who had or did not have a TAP block as part of their enhanced recovery after bariatric surgery protocol and multimodal analgesia (MMA) regimen.\u0000 \u0000 \u0000 \u0000 The study was a retrospective analysis of 149 primary totally robotic bariatric surgeries performed with (n = 75) or without (n = 74) TAP block between April 2022 and December 2022. Measures included: (1) patient characteristics, (2) surgical outcomes, and (3) early and late postoperative (PO) pain intensity and cumulative opioid needs. Pain scores and opioid usage were assessed in the post-anesthesia care unit (PACU) and the first 24 h of the hospital stay.\u0000 \u0000 \u0000 \u0000 Patient characteristics, operative time, time in PACU, and length of stay did not significantly differ between patients who had a TAP block and those who did not. Pain scores (early or late) did not differ significantly with or without TAP block, nor did 24-h opioid consumption (6.24 and 6.23 morphine milliequivalents) or the number of patients requiring opioids for pain management (37% vs. 42%, respectively). Surgery expenses were significantly higher with TAP block due to the added costs of the procedure ($713.31).\u0000 \u0000 \u0000 \u0000 TAP block had no additive benefit to our MMA regimen in reducing PO pain and opioid usage.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"16 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141007124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Insights and Future Directions in Gut Hormone Studies after Bariatric Metabolic Surgery: A Scoping Review","authors":"Mohamed Hany, B. Torensma","doi":"10.4103/jbs.jbs_18_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_18_23","url":null,"abstract":"\u0000 This scoping review evaluated three systematic reviews (SRs) (SR17, SR21, and SR23) on gut hormones after bariatric metabolic surgery (BMS) to pinpoint areas for methodological enhancement and further exploration. The combined assessment of 170 included studies showed a pooled prevalence of hormones and biomarkers as outcome parameters following BMS. The results indicate varying utilization rates of specific parameters across studies. Ghrelin was absent or not tested in 57.9%–90.9% of the studies, leptin in 25.3%–90.9%, peptide YY in 66.1%–85.3%, glucagon-like peptide-1 in 64.2%–82.1%, glucagon in 96.2%–97.9%, and lipids were absent or not tested in 31.8%–100% of the studies. None of the studies tested patients after weight regain or in revisional surgery on the effect on the gut hormones. In the studies, the average median number per patient varied from 7 to 19 in SR17 and SR21 and 30 to 73 in SR23, with a notable heterogeneity ranging from 53% to 91% for Tau2. Postprandial testing was not performed in SR21 and SR23. Future studies could use predefined clinical research forms and datasets to formulate detailed research. This can determine which gut hormones are crucial for research while also aiming to enhance power quality and reduce heterogeneity. Furthermore, expanding new SR with a focus on associated medical problems, revision surgery, weight regain, fasting and postprandial testing, and the role of the changes of each hormone after BMS on energy and glucose homeostasis could help the BMS field.","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139776981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methodological Insights and Future Directions in Gut Hormone Studies after Bariatric Metabolic Surgery: A Scoping Review","authors":"Mohamed Hany, B. Torensma","doi":"10.4103/jbs.jbs_18_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_18_23","url":null,"abstract":"\u0000 This scoping review evaluated three systematic reviews (SRs) (SR17, SR21, and SR23) on gut hormones after bariatric metabolic surgery (BMS) to pinpoint areas for methodological enhancement and further exploration. The combined assessment of 170 included studies showed a pooled prevalence of hormones and biomarkers as outcome parameters following BMS. The results indicate varying utilization rates of specific parameters across studies. Ghrelin was absent or not tested in 57.9%–90.9% of the studies, leptin in 25.3%–90.9%, peptide YY in 66.1%–85.3%, glucagon-like peptide-1 in 64.2%–82.1%, glucagon in 96.2%–97.9%, and lipids were absent or not tested in 31.8%–100% of the studies. None of the studies tested patients after weight regain or in revisional surgery on the effect on the gut hormones. In the studies, the average median number per patient varied from 7 to 19 in SR17 and SR21 and 30 to 73 in SR23, with a notable heterogeneity ranging from 53% to 91% for Tau2. Postprandial testing was not performed in SR21 and SR23. Future studies could use predefined clinical research forms and datasets to formulate detailed research. This can determine which gut hormones are crucial for research while also aiming to enhance power quality and reduce heterogeneity. Furthermore, expanding new SR with a focus on associated medical problems, revision surgery, weight regain, fasting and postprandial testing, and the role of the changes of each hormone after BMS on energy and glucose homeostasis could help the BMS field.","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"172 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139836564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of the 5th Bariatric and Metabolic Surgery Congress of Turkish Society for Metabolic and Bariatric Surgery, 23-26 November 2023","authors":"","doi":"10.4103/2949-6705.395484","DOIUrl":"https://doi.org/10.4103/2949-6705.395484","url":null,"abstract":"","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"67 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139837672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstracts of the 5th Bariatric and Metabolic Surgery Congress of Turkish Society for Metabolic and Bariatric Surgery, 23-26 November 2023","authors":"","doi":"10.4103/2949-6705.395484","DOIUrl":"https://doi.org/10.4103/2949-6705.395484","url":null,"abstract":"","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"60 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139777800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of Eating Screen in Hindi: A Step Forward to Combat an Under-researched Menace of Eating Disorders in India","authors":"K. Rina, Rosali Bhoi, A. Vindal, Pawanindra Lal","doi":"10.4103/jbs.jbs_14_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_14_23","url":null,"abstract":"\u0000 \u0000 \u0000 A culturally appropriate tool to screen and diagnose eating disorders (EDs) is lacking in India.\u0000 \u0000 \u0000 \u0000 This study aims to translate, adapt, and validate ED Diagnostic Scale (EDDS) in Hindi.\u0000 \u0000 \u0000 \u0000 Hindi translation of EDDS was done by three psychiatrists, two of whom were familiar with Western culture, their mother tongue being Hindi. The bilingual panel of experts, including three surgeons, one Professor in the English language, and one person with severe obesity (International English Language Testing System score Band 8.5) resolved translation inconsistencies. Back translation to the English language was done by an independent translator. Pretesting/focused-group discussion/cognitive interviewing was done in persons with severe obesity (n = 55). Hindi-version so-developed was administered to students (n = 120) after a week. Test–retest reliability was assessed. The original EDDS, Modified Weight Bias Internalization Scale (WBIS-M), and Fat Phobia Scale-Short Form (FPS-SF) were applied to 175 participants (students [n = 120], patients [n = 55]). The psychometric properties of Hindi-EDDS were investigated.\u0000 \u0000 \u0000 \u0000 The mean age of students and patients was 18.60 and 43.38 years, respectively. Students and patients’ mean body mass index was 21.77 and 43.21 kg/m2, respectively. Kaiser–Meyer–Olkin and Bartlett’s Test of Sphericity for sample adequacy were 0.859 and χ2 = 3155.775; P = 0.000, respectively. The Spearman–Brown coefficient for Hindi-EDDS was 0.755 and 0.707, respectively. Internal consistency (Cronbach’s alpha and Kuder–Richardson - 20) was α = 0.898. Cross-language concordance had a significant intra-class correlation coefficient (0.725–1.000). WBIS-M and FPS-SF showed a significant correlation with various items of Hindi-EDDS.\u0000 \u0000 \u0000 \u0000 The Hindi EDDS is a culturally sensitive tool with acceptable psychometric properties.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"13 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Bariatric Surgery on Type 2 Diabetes Mellitus Remission in Indian Population – A Review of Literature","authors":"Viswanath Tadikamalla, S. Saravana Kumar, X. L. J. Leo, P. P. Raj","doi":"10.4103/jbs.jbs_10_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_10_23","url":null,"abstract":"\u0000 Diabetes mellitus and obesity have touched the level of epidemic globally long back, and their prevalence is rapidly growing beyond the predicted rates. Indians (Asians in general) are at a high risk of developing both these diseases than the rest of the global population due to innumerable reasons that will be discussed later. Bariatric surgery has proven efficacy without any doubts standing as first and best among all available options in the effective treatment of both these diseases. Some metabolic surgeries have reported various remission rates ranging up to 100%. The authors aimed at analyzing the available literature quoting the remission of type 2 diabetes mellitus after bariatric surgery in Indian ethnicity.","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"2 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139440091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Sleeve Gastrectomy with Sleeve Jejunal Bypass: An Advantage over Other Bypass Procedures – Multicenter 3 and 5 year Data","authors":"S. Ugale, Rajkumar Palaniappan, Manoj Bharucha, A. Ugale, Nikhilesh Krishna, Akshan Ugale, Trilok Ram","doi":"10.4103/jbs.jbs_13_23","DOIUrl":"https://doi.org/10.4103/jbs.jbs_13_23","url":null,"abstract":"\u0000 \u0000 \u0000 The sleeve gastrectomy with sleeve jejunal (SG + SJ) bypass is a single anastomosis, sleeve plus procedure which was introduced as a loop modification of the transit bipartition and the single-anastomosis sleeve-ileal bypass, continuing with the original idea of maintaining biliary access by avoiding duodenal transection, while creating a functional bypass to achieve weight loss and resolution of the metabolic syndrome.\u0000 \u0000 \u0000 \u0000 This study was done to evaluate the extent of weight reduction, control of type 2 diabetes mellitus (T2DM), their maintenance up to 5 years, nutritional stability, and documentation of any complications, following this procedure.\u0000 \u0000 \u0000 \u0000 This is a retrospective analysis of prospectively collected data of patients who underwent SG + SJ bypass, with a follow-up of 1–5 years, in three centers, amounting to 112 patients. A SG is followed by anastomosis of a loop of jejunum, usually at 200 cm distal to the duodenojejunal flexure (sometimes at 150 cm or even 100 cm depending on total small bowel length [TSBL]), with the antrum. The cohort included 41 male and 71 female patients with a mean age of 42 years and mean preoperative body mass index (BMI) of 45.8 kg/m2 (range: 30.15–74.6 kg/m2). Seventy-three (65.2%) patients had T2DM, with mean glycated hemoglobin (HbA1c) of 7.5% (range: 4.9%–16%). The primary outcome of this study was weight loss and remission of T2DM, and the secondary outcome was its safety and nutritional stability.\u0000 \u0000 \u0000 \u0000 Of these 112 patients analyzed in this study, 110 (98.2%) followed up at 1 year, 45 out of 58 (77.6%) at 3 years, and 14 out of 25 (56%) at 5 years. Operative duration was 120–180 min with an average hospital stay of 2–4 days with no postoperative problems. The mean TSBL was 793 cm (range: 530–1035 cm); the mean common channel (CC) was 587 cm (range: 330–835). Reduction in BMI was observed from 45.8 to 28.2 kg/m2 at 1 year, 27.4 kg/m2 at 3 years, and 27.3 at 5 years. The mean percentage of total body weight loss was 37.9% at 1 year, 40.7% at 3 years, and 40.6% at 5 years. Remission of diabetes was seen in 98.6% at 1 year, 97% at 3 years, and 91.7 at 5 years, with a mean fall in HbA1c from 7.5% to 5.2% at 1 year, 5% at 3 years, and 4.96% at 5 years. No mortality was seen in any of these 112 patients. Four patients had complications such as nausea, vomiting, diarrhea, dumping syndrome, hypoproteinemia, and hypoalbuminemia. Two patients required a partial reversal of the procedure (disconnection of the jejunal bypass while retaining the sleeve), while the rest were managed conservatively.\u0000 \u0000 \u0000 \u0000 This procedure was found to be safe and effective in achieving and maintaining weight loss and diabetes remission, along with nutritional stability, even at 3 and 5-year follow-up; long-term data are awaited. It has the advantage of maintaining biliary access and if necessary a partial reversal can be done in a simpler manner compared to other bypass procedures.\u0000","PeriodicalId":511902,"journal":{"name":"Journal of Bariatric Surgery","volume":"9 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139439297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}