Slg bmi 30 35
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This document summarizes a study on sleeve gastrectomy outcomes in patients with a BMI between 30-35. The study analyzed 474 patients undergoing laparoscopic sleeve gastrectomy (LSG) between 2006-2014. It found that LSG led to an average weight loss from a preoperative BMI of 33.57 to 27.0 after 24 months and 27.02 after 36 months. Comorbidities like insulin resistance, dyslipidemia, and hypertension saw remission rates of over 90%, and complications from LSG were low at 1.4%. The conclusions were that LSG can be performed safely in patients with a BMI of 30-35, with comparable or better results to those with higher BMIs
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The document discusses various current and emerging bariatric surgery procedures and technologies, including sleeve gastrectomy, revisional surgeries, endoscopic procedures like TOGA and gastric stimulation devices. It provides an overview of the effectiveness and long-term outcomes of sleeve gastrectomy based on available studies. The future of obesity treatment is explored with possibilities like implantable gastric stimulators and technologies that monitor eating and activity patterns.
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Kular Medical Education & Research Society
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drkskular@gmail.com
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The Mini-Gastric Bypass: Best Rx Diabetes
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Dr K S Kular
Kular Medical Education & Research Society ,
Kular Group of Institutes ,
drkskular@gmail.com
www.kularhospital.com
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Why even consider the Mini-Gastric Bypass?
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Kular Medical Education & Research Society ,
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Sleeve gastrectomy has been shown to be an effective bariatric procedure for weight loss and resolution of comorbidities like diabetes. While initially used for patients with BMI over 35, recent evidence suggests sleeve gastrectomy may be appropriate for some patients with a BMI under 35. A study of over 450 patients in Brazil with a mean BMI of 29 who underwent sleeve gastrectomy and ileal interposition for diabetes found no mortality, low complications, and resolution of diabetes in the majority of patients. The author concludes it makes sense to offer sleeve gastrectomy to appropriately selected patients with a BMI under 35 given its safety profile and outcomes.
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Short and long term results of gastric bypass
Gastric bypass surgery results in significant and long-lasting weight loss and health improvements according to multiple studies:
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- A Swedish study found an average weight loss of over 30% of initial body weight 10 years after gastric bypass or other bariatric surgeries compared to continued obesity in control patients.
- Studies show gastric bypass reduces the risk of death by 89% over 5 years compared to continued obesity and resolves or significantly improves obesity-related conditions like type 2 diabetes in a high percentage of patients.
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Abstract, Academic Surgical Congress 2014:
See also: http://www.ncbi.nlm.nih.gov/pubmed/25472748
Introduction
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Methods:
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Effect of Transition to Stapled Anastomosis on Anastomotic Leak Rates and Ope...
Abstract, Academic Surgical Congress 2014:
See also: http://www.ncbi.nlm.nih.gov/pubmed/25472748
Introduction
Stapled gastrointestinal anastomosis has gained wide adoption among the surgical community for its ease, speed, and its applicability in laparoscopic surgery. Over the last decade, anastomotic stapling grew to become the commonplace technique for colon cancer surgery at our center. This abstract assesses whether the increasing adoption of anastomotic stapling affected the rate of anastomotic leaks and duration of surgery.
Methods:
All patients operated on at our center for colon cancer from 2004 through 2011 were included. Rates of anastomotic leaks were compared between hand-sewn and stapled anastomosis, calculating relative risks and using Fischer's exact test and Chi-square tests to assess for significance. Univariate and multivariate linear regression compared durations of surgery, with estimates of difference were expressed in minutes through the unstandardized B-coefficient.
Results:
A total of 1071 patients were included. The number of stapled anastomoses grew significantly from 31.6% in 2004 to 70.8% in 2011 (p<0.001).><0.001) but eventually significantly shorter (138 vs. 162.2 P=0.005). This difference remained significant after adjustment for ASA classification, procedure type, presence of adhesions and operating surgeon (B=28.0 minutes; 95%CI 12.2,43.8; P=0.001).
Conclusion
Stapled anastomoses did not increase anastomotic leak rates. If anything, leak rates appeared slightly lower. In addition, stapled anastomoses significantly shortened operation duration. With the benefit of being a tool that facilitates minimally invasive surgery, it is a safe way to improve efficiency, reduce costs and promotes faster and better recovery.
Mini-Gastric Bypass: Best Surgery;
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Kular Sleeve vs Mini-Gastric Bypass
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IN EVERY STUDY, by every measure, the Mini-Gastric Bypass is equal to or better than every other form of bariatric surgery
Aspectos paar decidir una conversión
The document discusses revisional bariatric surgery options for patients who experience weight regain or inadequate weight loss after an initial Roux-en-Y gastric bypass procedure (RYGBP). It reviews various surgical techniques for revising the gastric pouch size and shape, lengthening or shortening the Roux limb, and adding an adjustable gastric band. A summary of the author's experience with 212 revisional surgeries found that patients experienced significant additional weight loss, though complication rates were high at 26%. Most patients reported being satisfied with the results of revisional surgery.
Bariatric surgery complications
This chapter discusses the surgical management of obesity. It begins with an overview of the obesity epidemic, noting that over one-third of US adults are obese and rates are projected to rise further. Obesity is associated with numerous health conditions and significant economic costs to the healthcare system and workforce. Bariatric surgery has been shown to be an effective treatment for severe obesity, resulting in substantial and durable weight loss as well as improved health outcomes. The various bariatric procedures are reviewed, including Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding. Patient selection factors, pre-operative evaluation and preparation, and post-operative management are also covered.
Initial human experience with restrictive duodenal jejunal bypass liner for t...
This study evaluated the use of a duodenal-jejunal bypass liner (DJBL) with a restrictor orifice for weight loss in 10 obese patients over 12 weeks. Key results:
1) Patients experienced a mean excess weight loss of 40% and total weight loss of 16.7 kg by the end of the study.
2) Gastric emptying was delayed with the DJBL in place, returning to normal levels after its removal in most patients.
3) Episodes of nausea and abdominal pain required dilation of the restrictor orifice in most patients, but there were no clinically significant adverse events.
4) The DJBL with restrictor orifice promoted substantial weight loss
Comparison lsg and rygb 1 year study
This study compared outcomes of 50 patients who underwent laparoscopic sleeve gastrectomy (LSG) to 50 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) over 1 year. At 6 months, excess weight loss was higher after LSG (50.8% vs 41.7%), but comparable at 1 year (76.1% vs 62.2%). Resolution of comorbidities like diabetes and hypertension was also comparable. While early diabetes resolution was better with LRYGB, results matched at 1 year. Gastroesophageal reflux increased slightly with LSG (5% pre-op to 9% at 1 year). Complication rates were low and similar between groups
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Vooruitblik Marco van Dorst - bijeenkomst gemeente Sluis dd 17 februari 2011
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This document summarizes a study on the effects of sleeve gastrectomy on type 2 diabetic obese patients. 63 patients underwent sleeve gastrectomy and were followed for an average of 24 months. Prior to surgery, most patients had well-controlled type 2 diabetes treated with oral medications. After surgery, patients experienced significant weight loss and 87% achieved remission of their diabetes as measured by normal fasting blood glucose and HbA1c levels. There were no deaths or need for reoperation. The study concludes that sleeve gastrectomy is a safe and effective treatment for obese patients with well-controlled type 2 diabetes.
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Bariatric surgery is the most effective treatment for obesity, resulting in greater weight loss than diet and exercise alone. The three most common bariatric surgery procedures are sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding. Sleeve gastrectomy and Roux-en-Y gastric bypass typically result in 60-70% excess weight loss, while gastric banding results in less weight loss of around 50%. Bariatric surgery significantly improves or resolves obesity-related conditions like type 2 diabetes, hypertension, and sleep apnea. Complications can include leaks, strictures, nutritional deficiencies, and gallstones, but can often be managed endoscopically.
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This document discusses bariatric surgery as a treatment for diabetes. It notes that 240 million people worldwide currently have diabetes, a number expected to rise to 380 million by 2025. Bariatric surgeries like gastric banding, sleeve gastrectomy, and gastric bypass can result in significant and sustained weight loss, leading to remission of type 2 diabetes in 80% of patients. Both short-term changes in gut hormones and long-term changes in adipose tissue and adipokines contribute to improved glucose control after weight loss surgery. The author has received training in bariatric procedures and now regularly performs sleeve gastrectomies at their hospital to treat diabetes.
kidney stones are common after bariatric surgery
Kidney stones are more common after bariatric surgery compared to obese patients who do not undergo surgery. The study examined over 750 patients who had bariatric surgery and matched them to obese controls. New stone formation was significantly higher after surgery (11.0%) versus controls (4.3%). The risk was highest with malabsorptive procedures (hazard ratio of 4.15) and standard gastric bypass (hazard ratio of 2.13). Malabsorptive procedures also increased the risk of chronic kidney disease (hazard ratio of 1.96). Urine tests showed stone formers after surgery had higher urine oxalate and calcium oxalate supersaturation levels compared to non-stone formers or obese controls
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This document provides an overview of bariatric surgery in Odisha, India. It begins with definitions of bariatric surgery and classifications of BMI. It then discusses the comorbidities of obesity and guidelines for determining who is a suitable candidate for bariatric surgery. The document outlines various bariatric procedures including restrictive, malabsorptive, and combination procedures. It also discusses pre-op assessment, investigations, tools used in bariatric surgery, pathophysiology including the role of GI hormones, and videos demonstrating sleeve gastrectomy and Roux-en-Y gastric bypass procedures.
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The document discusses emerging endoscopic and neuromodulation procedures for obesity treatment as alternatives to conventional bariatric surgery. It describes several primary endoscopic bariatric procedures like ValenTx sleeve and TOGA that provide 15-40% excess weight loss. It also reviews implantable gastric stimulators like Transcend IGS, MetaCure, and VBLOC therapy that use electrical pulses to induce satiety and reduce appetite through vagal modulation, resulting in 10-35% excess weight loss. These new procedures aim to offer minimally invasive options for less severe obesity with fewer lifestyle changes compared to standard bariatric surgery.
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Bariatric surgery is associated with improved pregnancy outcomes such as lower rates of preeclampsia, gestational diabetes, and fetal macrosomia compared to obese women who did not undergo bariatric surgery. Several studies found lower rates of these complications after surgery, though results were mixed. There is also evidence of lower c-section rates after bariatric surgery compared to obese pregnant women without surgery based on multiple studies. However, interpretation of studies is limited by varying designs, small sample sizes, and different control and comparison groups.
Efectos metabólicos del by pass gástrico
The document discusses various metabolic effects and mechanisms of action of Roux-en-Y gastric bypass (RYGB) surgery based on several studies. It finds that RYGB is effective at inducing weight loss and remission or improvement of type 2 diabetes in both short and long term follow-ups. The surgery increases insulin secretion and sensitivity through multiple mechanisms such as stimulating incretin hormones like GLP-1 and PYY, as well as changes in adipokines, vagal tone, intestinal gluconeogenesis, and other factors. RYGB is also found to have durable effects, good safety profile, and reproducibility across studies.
Efectos metabólicos del by pass gástrico
The document discusses various metabolic effects and mechanisms of action of Roux-en-Y gastric bypass (RYGB) surgery based on several studies. It finds that RYGB is effective at inducing weight loss and remission or improvement of type 2 diabetes in both short and long term follow-ups. The surgery appears to work through caloric restriction as well as enhanced secretion of gut hormones like GLP-1 and PYY that promote satiety and insulin sensitivity independently of weight loss. RYGB also improves cardiovascular risk factors and mortality rates compared to controls or other bariatric procedures.
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The document discusses the metabolic effects of sleeve gastrectomy for treating obesity and diabetes. It finds that sleeve gastrectomy results in significant weight loss and resolution of diabetes in patients with BMI over 35. For patients with BMI between 30-35, sleeve gastrectomy also led to improved blood glucose levels, reduced medication use, and 70% resolution of diabetes after 1 year according to HbA1c levels. However, more randomized trials are still needed to determine if these effects are long-lasting for chronic diseases like diabetes.
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This document summarizes the results of a study on 6,385 patients who underwent mini-gastric bypass (MGB) surgery over 15 years. The mean preoperative weight was 143kg and BMI was 47. Complications occurred in 4.9% of patients, with 0.7% having leaks. Long-term follow up found 78% excess weight loss on average and only 4.9% weight regain after 10 years. The study concludes MGB is an effective and low-risk bariatric procedure that can also be easily revised if needed.
6,385 Consecutive Mini-Gastric Bypasses: 15 Years Later
This document summarizes the results of a study on 6,385 patients who underwent mini-gastric bypass (MGB) surgery over 15 years. The mean preoperative weight was 143kg and BMI was 47. Complications occurred in 4.9% of patients, with 0.7% having leaks. Long-term follow-up found 78% excess weight loss on average and only 4.9% weight regain after 10 years. The study concludes MGB is an effective procedure with relatively low risks and failures that can also be easily revised.
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Slg bmi 30 35
- 1. Sleeve gastrectomy in patientsSleeve gastrectomy in patients with BMI between 30 and 35with BMI between 30 and 35 M. Berry MD, P. Lamoza MD, L. Urrutia MD, A. Molina MD, E. Luna MD, F. Parra MD Unit of Bariatric & Metabolic Surgery Clinica Las Condes Santiago – Chile SAGES 2015 Nashville, TN, USA
- 3. IntroductionIntroduction • The laparoscopic sleeve gastrectomy (LSG) is a bariatric procedure that has been extended to special cases with BMI under 35. • The real benefit is under investigation, but previous studies have shown beneficial results and safety. • We try to demonstrate that LSG can be performed safely in patients with BMI between 30-35 obtaining comparable results to severe and morbidly obese patients, with resolution of their comorbidities.
- 4. LSGLSG • LSG became the most widespread procedure in our country with excellent results in weight loss and acceptable morbimortality
- 5. Methods and ProceduresMethods and Procedures • Prospective study. • We analyzed 474 patients from a universe of 1605 patients with LSG. • Analyzing gender, age, comorbidities, preoperative BMI, EWL, EWL% and BMI postoperatively at 1,6,12,24 and 36 months, morbidity and mortality, (between 2006 and 2014.)
- 6. ResultsResults BMI 33,57 27,00 27,02 0 5 10 15 20 25 30 35 40 Preoperative 24 months postop. 36 months postop. Kg/Mts2
- 7. ResultsResults • Mean Weight: 89,8(68 – 114) kg • Surgical time: 86,1(40 – 120)min
- 8. Comorbidities and RemissionComorbidities and Remission 0 50 100 150 200 250 300 350 400 InsulinResistence Dyslipidemia Fatty Liver Disease Hypertension ObstructiveSleep Apnea Hyperuricemia Hypothyroidism Type2Diabet es (T2DM) Comorbiditites Remission 93% 90% 70% 70% 72% 82%* * Improvement T2DM 18% (n:6)
- 9. MorbidityMorbidity Morbidity n rate Hemoperitoneum 5 1,0 Portal Vein Thrombosis 1 0,2 Bile Peritonitis (Lushka -cholecystectomy) 1 0,2 Leaks 0 0,0 Total Cases 7 1,4
- 10. ConclusionsConclusions • Clearly, BMI is not the only indicator to consider bariatric and metabolic surgery; there are other variables to consider in a complete preoperative evaluation. • Our results have shown that performing LSG in patients with BMI between 30 and 35 is safe • The results are comparable or even better than those obtained in patients with severe or morbid obesity in terms of resolution of comorbidities and weight loss • It will require further studies and longer follow-up.
- 11. • Thank you for your attention!!