Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-24
I. Ertuğrul
{"title":"AB013. OP-13 Laparoscopic approach to gastrogastric fistula and enteroenterostomy anastomosis stricture after laparoscopic gastric bypass","authors":"I. Ertuğrul","doi":"10.21037/ales-2019-bms-24","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-24","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49328560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-39
S. Dogan, A. Ipor, M. Pehlivan
Background: Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for the treatment of obesity. Although the causes of failure after bariatric surgery are unknown, it is thought that there may be a high residual gastric volume. Objective is to evaluate the effects of resected gastric volume and residual gastric volumes after LSG on weight loss. Methods: A single-center retrospective study including 12 months follow-up. Sixty-seven patients with LSG were enrolled. Technically, after the closure of the pylori with a laparoscopic clamp, an orogastric tube was injected with methylene-blue saline intraluminal pine-tip syringe and the residual stomach was given in full view. The amount of fluid given was noted when the remaining gastric tissue stopped expansion. Simultaneously, leakage testing is also routinely performed. 20 mmHg CO2 gas was delivered to the resected stomach tissue until the air leaked from the stomach and noted. In addition, the resected gastric tissue was filled with saline until the fluid leaked from the stapler line. The patients were divided into three groups according to the remaining gastric tissue volume: (I) group below <60 cc, (II) group 60≤90 cc, (III) group <90 cc and above. BMI, total weight loss, weight loss percentage (EWL%) variables were calculated at 6 and 12 months after LSG. Results: All patients were included in the database after 1 year of follow-up. Sixty-seven patients (57 F/10 M) with a mean age of 36 years (17–56 years) were included in the study. One patient was excluded because the gastric tissue was perforated while removing from the abdomen and 4 patients did not come to the control. The remaining 62 patients were evaluated. The average total stomach volume of patients was 1,280 cc (660–1,945 cc), residual gastric tissue volume was 68 cc (35–120 cc), the volume of the removed stomach was 1,212 cc (600–1,900 cc) and CO2 gas given to the extracted stomach tissue was 1 liter (20 mmHg) (0.5 to 1.4), respectively. Mean body mass index (BMI) was calculated as 47.30 kg/m preoperatively, 30.10 kg/m BMI at the end of the first year after LSG. In Group 1,% EWL was 69.22% in 6 months and% EWL% 79.77 in 1 year; In group 2, EWL% 62.62 in 6 months, EWL% 75.04 in 1 year; In group 3, EWL was 66.74% in 6 months and EWL 72.12% in 1 year. In general, satisfactory weight loss was seen in groups 1 and 2 within 1 year (EWL% 70). In group 3, it was close to these values but not statistically significant. As shown in this graph, although it is not statistically significant, weight loss increases as RGV decreases. Conclusions: The main findings of this study indicate that RGV significantly increases weight loss following surgery. However, although the volume increase in RGV reduced weight loss numerically, this was not statistically significant. The most important mechanism of LSG is to limit food intake by reducing stomach volume. Therefore, postoperative gastric volume is necessary to obtain optimum postoperative
{"title":"AB028. PP-7 Is there a correlation between residual gastric volume and weight loss?—1 year results","authors":"S. Dogan, A. Ipor, M. Pehlivan","doi":"10.21037/ales-2019-bms-39","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-39","url":null,"abstract":"Background: Laparoscopic sleeve gastrectomy (LSG) has become a popular procedure for the treatment of obesity. Although the causes of failure after bariatric surgery are unknown, it is thought that there may be a high residual gastric volume. Objective is to evaluate the effects of resected gastric volume and residual gastric volumes after LSG on weight loss. Methods: A single-center retrospective study including 12 months follow-up. Sixty-seven patients with LSG were enrolled. Technically, after the closure of the pylori with a laparoscopic clamp, an orogastric tube was injected with methylene-blue saline intraluminal pine-tip syringe and the residual stomach was given in full view. The amount of fluid given was noted when the remaining gastric tissue stopped expansion. Simultaneously, leakage testing is also routinely performed. 20 mmHg CO2 gas was delivered to the resected stomach tissue until the air leaked from the stomach and noted. In addition, the resected gastric tissue was filled with saline until the fluid leaked from the stapler line. The patients were divided into three groups according to the remaining gastric tissue volume: (I) group below <60 cc, (II) group 60≤90 cc, (III) group <90 cc and above. BMI, total weight loss, weight loss percentage (EWL%) variables were calculated at 6 and 12 months after LSG. Results: All patients were included in the database after 1 year of follow-up. Sixty-seven patients (57 F/10 M) with a mean age of 36 years (17–56 years) were included in the study. One patient was excluded because the gastric tissue was perforated while removing from the abdomen and 4 patients did not come to the control. The remaining 62 patients were evaluated. The average total stomach volume of patients was 1,280 cc (660–1,945 cc), residual gastric tissue volume was 68 cc (35–120 cc), the volume of the removed stomach was 1,212 cc (600–1,900 cc) and CO2 gas given to the extracted stomach tissue was 1 liter (20 mmHg) (0.5 to 1.4), respectively. Mean body mass index (BMI) was calculated as 47.30 kg/m preoperatively, 30.10 kg/m BMI at the end of the first year after LSG. In Group 1,% EWL was 69.22% in 6 months and% EWL% 79.77 in 1 year; In group 2, EWL% 62.62 in 6 months, EWL% 75.04 in 1 year; In group 3, EWL was 66.74% in 6 months and EWL 72.12% in 1 year. In general, satisfactory weight loss was seen in groups 1 and 2 within 1 year (EWL% 70). In group 3, it was close to these values but not statistically significant. As shown in this graph, although it is not statistically significant, weight loss increases as RGV decreases. Conclusions: The main findings of this study indicate that RGV significantly increases weight loss following surgery. However, although the volume increase in RGV reduced weight loss numerically, this was not statistically significant. The most important mechanism of LSG is to limit food intake by reducing stomach volume. Therefore, postoperative gastric volume is necessary to obtain optimum postoperative ","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47418782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-37
S. Atıcı, C. Arıcan, L. Uğurlu, C. Aydın
{"title":"AB026. PP-5 Petersen hernia—a rare cause of acute abdomen after laparoscopic gastric by-pass operation","authors":"S. Atıcı, C. Arıcan, L. Uğurlu, C. Aydın","doi":"10.21037/ales-2019-bms-37","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-37","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42139198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-21
Ozan Şen, F. Karaca, A. Türkçapar
{"title":"AB010. OP-10 Gastroesophageal reflux disease after sleeve gastrectomy—incidence and effectiveness of technical modifications","authors":"Ozan Şen, F. Karaca, A. Türkçapar","doi":"10.21037/ales-2019-bms-21","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-21","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42475273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-32
Ö. Özozan, C. E. Guldogan, E. Gündoğdu, Mehmet Mahir Özmen
Background: The clinical results of obese patients who have undergone open or laparoscopic appendectomy, whether one technique is superior to the other is still not clearly known. In our study, we compared the clinical results of obese patients operated with laparoscopic or open technique for acute appendicitis. Methods: We performed retrospective analyses of patients operated for acute appendicitis between the dates of July 2016 and July 2019 at Istinye University Faculty of Medicine Bahçeşehir Liv Training and Research Hospital and Liv Hospital Ankara. Of 241 patients whose height and weight information were accessible, 57 had a BMI of 30 kg/m or higher. Eighteen of these patients underwent open surgery while the other 39 underwent laparoscopic surgery. The primary result criterion was complication ratio. The secondary criteria were operation time and length of hospital stay. Results: Upon comparison of laparoscopic and open techniques in terms of intraoperative-postoperative complications, operation time and length of hospital stay; statistically significant differences were found between the groups. Conclusions: In obese appendicit is patients, the laparoscopic technique proved to be superior to the open technique in criteria such as perioperative-postoperative complications and operation time etc. The length of hospital stay was determined to be similar between the groups.
{"title":"AB021. OP21 Obesity and appendicitis: laparoscopy vs. open technique","authors":"Ö. Özozan, C. E. Guldogan, E. Gündoğdu, Mehmet Mahir Özmen","doi":"10.21037/ales-2019-bms-32","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-32","url":null,"abstract":"Background: The clinical results of obese patients who have undergone open or laparoscopic appendectomy, whether one technique is superior to the other is still not clearly known. In our study, we compared the clinical results of obese patients operated with laparoscopic or open technique for acute appendicitis. Methods: We performed retrospective analyses of patients operated for acute appendicitis between the dates of July 2016 and July 2019 at Istinye University Faculty of Medicine Bahçeşehir Liv Training and Research Hospital and Liv Hospital Ankara. Of 241 patients whose height and weight information were accessible, 57 had a BMI of 30 kg/m or higher. Eighteen of these patients underwent open surgery while the other 39 underwent laparoscopic surgery. The primary result criterion was complication ratio. The secondary criteria were operation time and length of hospital stay. Results: Upon comparison of laparoscopic and open techniques in terms of intraoperative-postoperative complications, operation time and length of hospital stay; statistically significant differences were found between the groups. Conclusions: In obese appendicit is patients, the laparoscopic technique proved to be superior to the open technique in criteria such as perioperative-postoperative complications and operation time etc. The length of hospital stay was determined to be similar between the groups.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41596359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-28
Fusun Ozmen, Gul Ozge Ergen, Mehmet Mahir Özmen
Background: Morbid obesity is a multifactorial disease and associated with genetic and environmental factors. Adipose tissue remodeling is created with adiposity hypertrophia and activation of immune cells. Human Leukocyte Antigen (HLA) loci are also related to some inflammatory and autoimmune diseases. HLA molecules present peptids to T cells and triger the inflammation. The present study aims to analyze the association HLA class I and class II alleles with morbid obesity disease. Methods: HLA class I and class II alleles frequency was investigated in 80 (10 M) morbidly obese patients with 51 (40–68) kg/m BMI who underwent obesity surgery. The control population was created from 100 healthy donors. HLA genotyping was performed using the PCR-SSO method at the low-resolution level. Chi-square and Fisher’s exact test were used for statistical evaluation. Results: When evaluated HLA class I alleles, eighteen HLA-A, twenty five HLA-B and twelve HLA-C different alleles were detected in two groups. We found that alleles frequency were very similar for all HLA class I loci in obese and control groups, although HLA-B*45 (8%) (P=0.001) and HLA*C*15 (10%) (P=0.04) alleles frequency in the patient population were significantly higher than the control group. Eighteen different HLA class II alleles were identified in this study. The certain HLA alleles frequencies in the patient population including HLADRB1*03 (13.13%), -DRB1*04 (22.5%), -DRB1*08 (5.63%), -DRB1*09 (1.25%), -DRB1*12 (1.88%), -DRB1*14 (6.25%), -DRB1*16 (6.88%) were higher than the controls, only -DRB1*03 and -DRB1*04 frequencies reached statistical significance (respectively, P=0.05 and P=0.012). HLA-DRB1*01 (5%, P=0.029), HLA-DRB1*13 (5%, P=0.001) and HLA-DQB1*06 (8.75%, P=0.006) alleles were lower frequency alleles in patients and differed significantly from the healthy controls. Conclusions: Present study demonstrates that certain HLA alleles were found to be higher in the patient population. HLA class I and class II molecules present the foreign peptides to CD8 T cells and CD4+ T cells, respectively and promote to activation of the adaptive immune system. We conclude that as these alleles might be important for triggering the inflammation in adipose tissue, they might be associated with morbid obesity. Although presenting peptides are important as much as HLA alleles in morbid obesity. However, new researches including HLA molecule-peptid-T Cell Receptor and larger patient population are needed.
{"title":"AB017. OP17 Are there any specific HLA alleles related to morbid obesity in Turkish population","authors":"Fusun Ozmen, Gul Ozge Ergen, Mehmet Mahir Özmen","doi":"10.21037/ales-2019-bms-28","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-28","url":null,"abstract":"Background: Morbid obesity is a multifactorial disease and associated with genetic and environmental factors. Adipose tissue remodeling is created with adiposity hypertrophia and activation of immune cells. Human Leukocyte Antigen (HLA) loci are also related to some inflammatory and autoimmune diseases. HLA molecules present peptids to T cells and triger the inflammation. The present study aims to analyze the association HLA class I and class II alleles with morbid obesity disease. Methods: HLA class I and class II alleles frequency was investigated in 80 (10 M) morbidly obese patients with 51 (40–68) kg/m BMI who underwent obesity surgery. The control population was created from 100 healthy donors. HLA genotyping was performed using the PCR-SSO method at the low-resolution level. Chi-square and Fisher’s exact test were used for statistical evaluation. Results: When evaluated HLA class I alleles, eighteen HLA-A, twenty five HLA-B and twelve HLA-C different alleles were detected in two groups. We found that alleles frequency were very similar for all HLA class I loci in obese and control groups, although HLA-B*45 (8%) (P=0.001) and HLA*C*15 (10%) (P=0.04) alleles frequency in the patient population were significantly higher than the control group. Eighteen different HLA class II alleles were identified in this study. The certain HLA alleles frequencies in the patient population including HLADRB1*03 (13.13%), -DRB1*04 (22.5%), -DRB1*08 (5.63%), -DRB1*09 (1.25%), -DRB1*12 (1.88%), -DRB1*14 (6.25%), -DRB1*16 (6.88%) were higher than the controls, only -DRB1*03 and -DRB1*04 frequencies reached statistical significance (respectively, P=0.05 and P=0.012). HLA-DRB1*01 (5%, P=0.029), HLA-DRB1*13 (5%, P=0.001) and HLA-DQB1*06 (8.75%, P=0.006) alleles were lower frequency alleles in patients and differed significantly from the healthy controls. Conclusions: Present study demonstrates that certain HLA alleles were found to be higher in the patient population. HLA class I and class II molecules present the foreign peptides to CD8 T cells and CD4+ T cells, respectively and promote to activation of the adaptive immune system. We conclude that as these alleles might be important for triggering the inflammation in adipose tissue, they might be associated with morbid obesity. Although presenting peptides are important as much as HLA alleles in morbid obesity. However, new researches including HLA molecule-peptid-T Cell Receptor and larger patient population are needed.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46082172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-27
Ç. Pekşen, O. A. Savaş, T. Vartanyan, I. Yurdaışık, H. Yetis, A. Sümer
{"title":"AB016. OP16 Alternative method for the deployment of endoscopic stents in sleeve gastrectomy leaks","authors":"Ç. Pekşen, O. A. Savaş, T. Vartanyan, I. Yurdaışık, H. Yetis, A. Sümer","doi":"10.21037/ales-2019-bms-27","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-27","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45785270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-36
L. Uğurlu, T. Kaya, S. Salimoğlu, C. Aydın
{"title":"AB025. PP-4 Cases gastric stenosis after laparoscopic sleeve gastrectomy","authors":"L. Uğurlu, T. Kaya, S. Salimoğlu, C. Aydın","doi":"10.21037/ales-2019-bms-36","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-36","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44914819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-23
H. Çiyiltepe, A. Karip, N. Bulut, M. Fersahoğlu
{"title":"AB012. OP-12 Revision surgery experience in patients with sleeve gastrectomy failed in weight loss","authors":"H. Çiyiltepe, A. Karip, N. Bulut, M. Fersahoğlu","doi":"10.21037/ales-2019-bms-23","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-23","url":null,"abstract":"","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42065230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-30DOI: 10.21037/ales-2019-bms-33
A. Ergin, B. Topaloğlu, H. Çiyiltepe, M. Fersahoğlu, N. Bulut, A. Karip
Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly used bariatric surgical method. One of the complications seen after LSG is Trocar Site Hernia (TSH). The rate of TSH detected radiologically after LSG has been reported to be 19%. Failure to adequately expose fascia defect due to the thick abdominal wall, limitation of instrument movement due to excessive subcutaneous fatty tissue, are the accused reasons for increased TSH among obese population. In this study, we aimed to determine TSH ratio and its causes after LSG. Methods: The patients who underwent LSG between January 2016 and June 2017 and trocar sites were closed by using Carter-Thomason Suture Passer were first evaluated by phone calls. Demographic characteristics and postoperative weight loss were recorded in patients who agreed to participate in the study and all were invited to a physical exam. At the control, hernia examination was performed by a general surgeon who was trained in ultrasonographic hernia detection in the radiology clinic. The detected TSHs were divided into two groups as symptomatic and asymptomatic. The data obtained were evaluated with SPSS 23 program. P value below 0.05 was considered significant. Results: Sixty-one patients were included in the study. The mean time from LSG was 32 (min 24, max 43) months. Totally 7 (11.4%) TSHs were detected in 61 patients, symptomatic in two and asymptomatic in 5 patients. BMI above 30 kg/m and age over 40 years at control were found to be a significant factor for TSH occurrence (P<0.05). Repair of fascia defects with Carter-Thomason Suture Passer during LSG reduces the frequency of TSH (11.4% vs. 19%). Conclusions: Advanced age and inadequate weight loss are factors that increase the rate of TSH after LSG. CarterThomason Suture Passer might reduce the TSH rate among morbidly obese patients.
{"title":"AB022. PP-1 Rate of trocar site hernia after laparoscopic sleeve gastrectomy","authors":"A. Ergin, B. Topaloğlu, H. Çiyiltepe, M. Fersahoğlu, N. Bulut, A. Karip","doi":"10.21037/ales-2019-bms-33","DOIUrl":"https://doi.org/10.21037/ales-2019-bms-33","url":null,"abstract":"Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly used bariatric surgical method. One of the complications seen after LSG is Trocar Site Hernia (TSH). The rate of TSH detected radiologically after LSG has been reported to be 19%. Failure to adequately expose fascia defect due to the thick abdominal wall, limitation of instrument movement due to excessive subcutaneous fatty tissue, are the accused reasons for increased TSH among obese population. In this study, we aimed to determine TSH ratio and its causes after LSG. Methods: The patients who underwent LSG between January 2016 and June 2017 and trocar sites were closed by using Carter-Thomason Suture Passer were first evaluated by phone calls. Demographic characteristics and postoperative weight loss were recorded in patients who agreed to participate in the study and all were invited to a physical exam. At the control, hernia examination was performed by a general surgeon who was trained in ultrasonographic hernia detection in the radiology clinic. The detected TSHs were divided into two groups as symptomatic and asymptomatic. The data obtained were evaluated with SPSS 23 program. P value below 0.05 was considered significant. Results: Sixty-one patients were included in the study. The mean time from LSG was 32 (min 24, max 43) months. Totally 7 (11.4%) TSHs were detected in 61 patients, symptomatic in two and asymptomatic in 5 patients. BMI above 30 kg/m and age over 40 years at control were found to be a significant factor for TSH occurrence (P<0.05). Repair of fascia defects with Carter-Thomason Suture Passer during LSG reduces the frequency of TSH (11.4% vs. 19%). Conclusions: Advanced age and inadequate weight loss are factors that increase the rate of TSH after LSG. CarterThomason Suture Passer might reduce the TSH rate among morbidly obese patients.","PeriodicalId":8024,"journal":{"name":"Annals of Laparoscopic and Endoscopic Surgery","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.21037/ales-2019-bms-33","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44056032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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