RESUMO
BACKGROUND: Attempts are being made in recent years to replace open surgery with endoscopic techniques in some obese patients when medical treatment fails, as they are considered to be less-invasive procedures. To date, there is little scientific evidence regarding their effectiveness. CLINICAL CASES: The cases are reported of 2 patients who attended our surgery looking for an effective bariatric surgical treatment after failed endoscopic sleeve gastroplasty. CONCLUSIONS: Laparoscopic sleeve gastrectomy after failure of an endoscopic technique does not offer great variation from the standard technique.
Assuntos
Cirurgia Bariátrica/métodos , Gastroplastia/métodos , Reoperação/métodos , Adulto , Feminino , Gastrectomia/métodos , Gastroscopia/métodos , Humanos , Masculino , Estômago/diagnóstico por imagem , Técnicas de Sutura , Aderências Teciduais/cirurgiaRESUMO
BACKGROUND: Laparoscopic sleeve gastrectomy is a surgical procedure for the treatment of morbid obesity. However, there are still controversies regarding its efficiency in terms of weight reduction and incidence of complications. In this prospective study, the experience is presented of a referral centre for the treatment of morbid obesity with laparoscopic sleeve gastrectomy. MATERIAL AND METHODS: A prospective study on 73 patients subjected to laparoscopic sleeve gastrectomy from February 2009 to September 2013. Patients were followed-up for a period of 12 months, evaluating the development of complications, reduction of gastric volume, and the weight loss associated with the surgery, as well as their impact on the improvement of comorbidities present at beginning of the study. RESULTS: There was a statistically a significantly reduction between the preoperative body mass index (BMI) and the BMI at 12 months after laparoscopic sleeve gastrectomy (p < 0.001), despite there being an increase in the gastric volume during follow-up, measured at one month and 12 months after surgery (p < 0.001). Five patients (6.85%) had complications, with none of them serious and with no deaths in the whole series. CONCLUSIONS: Laparoscopic sleeve gastrectomy is a safe and effective technique for the treatment of morbid obesity. Its use is associated with a significant reduction in the presence of comorbidities associated with obesity. Multicentre studies with a longer period of monitoring are required to confirm the efficacy and safety of this surgical technique.
Assuntos
Cirurgia Bariátrica/métodos , Gastrectomia/métodos , Laparoscopia/métodos , Obesidade Mórbida/cirurgia , Estômago/patologia , Adolescente , Adulto , Índice de Massa Corporal , Comorbidade , Diabetes Mellitus Tipo 2/complicações , Feminino , Seguimentos , Humanos , Curva de Aprendizado , Masculino , Síndrome Metabólica/complicações , Pessoa de Meia-Idade , Tamanho do Órgão , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do Tratamento , Adulto JovemRESUMO
Bariatric surgery requires a high level of training and detailed knowledge of advanced laparoscopy, especially when carrying out intracorporeal anastomosis. The following presentation shows two examples used by our group, which consists of slipknots done at the beginning and the end of the thread that allows us to do the suture quickly and securely.
La práctica de la cirugía bariátrica requiere adiestramiento especial, con dominio de la laparoscopia avanzada, sobre todo en la realización de anastomosis intracorporales. Enseguida se exponen dos recursos utilizados por nuestro grupo que consisten en "lazos corredizos" que se realizan al inicio y al final del hilo y que permiten efectuar la sutura de forma rápida y segura.