Effectiveness of intragastric balloon as a bridge to definitive bariatric surgery in the super-obese endoscopic and percutaneous interventional procedures (2017)

Type of publication:
Conference abstract

Author(s):
*Ball W.; *Raza S.S.; *Loy J.; *Riera M.; *Pattar J.; *Adjepong S.; *Rink J.; *Lyons H.; *Price B.

Citation:
Obesity Surgery; Jul 2017; vol. 27 (Supplement 1); p. 335

Abstract:
Introduction: Super Obese patients with body mass index (BMI) > 60KG/M2 pose particular difficulties for primary laparoscopic bariatric surgery. Laparoscopic port access, stapling and suturing become increasingly difficult with higher BMI. Our unit’s practice of placing an intragastric balloon for 6 months prior to definitive surgery in patients with BMI > 60KG/M2 aims to make definitive surgery less difficult by reducing weight. Objectives: To quantify weight loss after balloon placement and determine if these patients subsequently underwent definitive bariatric surgery. Methods: Retrospective review of 46 consecutive patients with intragastric balloon placement using SPSS statistical analysis on the results. Results: Median weight loss 14kg (0-42) P<0.0001, median % excess weight loss (%EWL) 15% (-3.3-64.66) P<0.001 and median BMI reduction 5KG/M2 (-1.3-13.9) P<0.001. 29/46 (63%) patients underwent definitive bariatric surgery. 10/46 (22%) patients had minor complications (nausea, vomiting and pain) requiring re-admission, of these 7/10 (70%) had early balloon removal and 6/10 (60%) did not have definitive bariatric surgery. 6/46 patients had second balloon placement median weight loss-6kg (-22-33), median %EWL-4.85% (-21.6-34.96), median BMI reduction-1.3KG/M2 (-8.5-2.5). Conclusion: Results from intragastric balloon placement are encouraging and comparable with a recent metaanalysis. Re-admissions and low %EWL with the first balloon are predictors for early balloon removal and failure to proceed to definitive surgery. Intragastric balloons as a bridge to definitive bariatric surgery are effective and safe. Sequential intragastric balloons are not recommended.

Comparing quality of life outcomes between Laparoscopic Sleeve Gastrectomy and Laparoscopic RouxY Gastric Bypass using the RAND36 questionnaire (2017)

Type of publication:
Journal article

Author(s):
*Macano C.A.W.; *Brookes A.; *Lafaurie G.; *Riera M.; Nyasavajjala S.M.

Citation:
International Journal of Surgery; Jun 2017; vol. 42 ; p. 138-142

Abstract:
Background Obesity surgery is an effective treatment to improve the health of patients. There is a lack of data regarding weight loss surgery outcomes and effects on Quality of Life (QoL). This study aims to compare¬†changes in QoL following either Laparoscopic Sleeve Gastrectomy (LSG) or Laparoscopic Roux-en-Y Gastric Bypass (LRYGB). Methods SF36 questionnaires were mailed to all LSG and LRYGB patients who underwent surgery in 2013. Demographic data was obtained from hospital records. Statistical analysis was undertaken using Stats direct. Results 158 patients were sent postal questionnaires. 60 were returned (38%). 41 were women, 16 LSG, 44 LRYGB, mean age 52 years, mean BMI pre-surgery 41.0. Both procedures yielded similar weight loss over 2 year follow up (p = 0.01), and similar improvements in obesity related co-morbidities. These procedures yielded significant improvements in all QoL scales and domains other than the emotional role limitations scale following sleeve gastrectomy. Conclusion Bariatric surgery has been shown to improve a patient’s QoL. More research is needed to explain the reasons why there was a difference between Sleeve and Bypass procedures in emotional changes to patients.

Recurrent laryngeal nerve palsy due to displacement of a gastric band (2016)

Type of publication:
Journal article

Author(s):
*Fussey, J M, *Ahsan, F

Citation:
Annals of the Royal College of Surgeons of England, Nov 2016, vol. 98, no. 8, p. e152

Abstract:
The left recurrent laryngeal nerve is at increased risk of compression by oesophageal pathology due to its long course through the neck and thorax. Here we report a case of left vocal cord palsy secondary to displacement of a gastric band, resulting in oesophageal dilatation and neuropraxia of the left recurrent laryngeal nerve. Vocal cord function partially improved following removal of the gastric band.