Performing a banded bypass as a primary procedure has grown in popularity as surgeons loom for ways to prevent weight regain in patients. However, the banded bypass is also performed as a redo procedure in many centres. Bariatric News talks to Dr Jody Valk, Department of General Surgery, ZNA Stuivenberg Hospital, Antwerp, Belgium, who discusses why his centre utilise a band to help patients loose regained weight.
A recent paper, ‘Banded Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity’, published in Surgery for Obesity and Related Diseases (SOARD), concluded that the banded bypass procedure is safe and may provide better weight loss in super-obese patients. Bariatric News talked to one of the study’s authors, Dr Philip Schauer (Bariatric and Metabolic Institute, Cleveland Clinic, Cleveland, OH), about the study and benefits of the procedure…
Bariatric News talked to Professor Rudolph Weiner, Head of the Department of Surgery of the Frankfurt Sachsenhausen Hospital, Frankfurt, Germany, who discussed the growing trend of using a ring in gastric bypass and sleeve gastrectomy procedures. He cited the example of a sleeve gastrectomy where the antrum region of the stomach, before the pylorus, can become dilated and as a result the capacity of the sleeve increases.
Roux-en Y gastric laparoscopic bypass is associated with longterm weight loss, as well as reducing the rates of diabetes remission and lowering the risk of cardiovascular and other health outcomes1. Nevertheless, in some patients, the bypass will fail leading to patients regain weight.
In March 2012, Bariatric Solutions introduced a re-useable retrogastric dissector for single hand tissue tunnelling during bariatric procedures. Called the PinkyTrigger, the laparoscopic 5mm instrument is easy to use and incorporates a dynamic lever facilitating the curve the tip of the instrument to a maximum angle of 130° in an uninterrupted fashion.
Bariatric News spoke to Dr Paul Super, Birmingham, UK, who has performed over 200 laparoscopic gastric band procedures with the PinkyTigger, to discuss the benefits of using the device.
Robotic laparoscopic sleeve gastrectomy (LSG) results in the resolution of type 2 diabetes, a reduction in hypertension, and carries a low risk of complications, according to Professor Ralf Konstantin Senner, Lindberg Hospital/GSMN,Winterthur, Switzerland.
“The euphoria regarding gastric banding ended in 2005 and sleeve gastrectomy was a new option,” said Senner. “Many bariatric surgeons were skeptical about the procedure and about the results. However, we learned with every new patient and each new surgery, our experience increased.
It is clear by now that after five years the standard Roux en Y bypass is faced with a considerable amount of re-operations due to weight regain. This can result in up to 30 to even 50% of the initial patients requiring revisional surgery. The main reason for the weight regain is the dilatation of the gastric pouch, eventually accompanied by dilatation of the anastomosis and/or small bowel.
Researchers Mark Castleberry, a doctoral student, and professor Sean Davidson, both in the UC College of Medicine, have found a way to produce Apolipoprotein A5 (APOA 5) protein in the laboratory. It plays an important role in metabolising and clearing excess levels of triglycerides from the bloodstream. Their findings, ‘Functional recombinant apolipoprotein A5 that is stable at high concentrations at physiological pH’, were published in the Journal of Lipid Research.
The UK's National Health Service (NHS) needs to do more to address the ingrained stigma and discrimination faced by people with obesity, according to Dr Stuart Flint, Associate Professor in the Psychology of Obesity at the University of Leeds, who believes that negative attitudes around weight gain are pervasive in the NHS and they can affect the way patients are treated.
Bariatric surgery significantly reduces colorectal cancer (CRC) risk in patients with obesity to the extent that they share the same risk of colorectal cancer as the general population, according to researchers from Université Côte d’Azur, Nice, France. However, for patients with obesity who do not undergo bariatric surgery, the risk is 34% above that of the general population.
The American College of Surgeons has issued guidelines for the triage of metabolic and bariatric surgery (MBS) patients, as part of its Coronavirus Disease 2019 (COVID-19) and Surgery online resource for the surgical community facing the impact of COVID-19.
