Erridge and you can associates (2016) summarized the systematic applications of pure opening transluminal endoscopic businesses (NOTES) for the bariatric functions
These types of investigators carried out a review of data, up to out of procedure and you may negative effects of bariatric Notes tips. A total of nine products were as part of the latest data jak funguje afroromance, which have several other six records outlining endolumenal actions incorporated having analysis. Every Cards training then followed a hybrid processes. Hybrid Notes sleeve gastrectomy (hNSG) is actually explained for the cuatro people and you can 2 porcine training. Into the individuals, six victims (23.step 1 %) was indeed transformed into conventional laparoscopic actions, and you may 1 article-surgical side effects (step three.8 %) are claimed. Suggest additional weight losses was 46.6 % (list of thirty five.dos so you’re able to 58.9). The experts figured transvaginal-helped arm gastrectomy featured possible and you will secure whenever performed by correctly instructed experts. But not, it reported that improvements should be designed to defeat newest technology restrictions.
An UpToDate opinion to your “Natural beginning transluminal endoscopic procedures (NOTES)” (Pasricha and you may Rivas, 2018) claims you to definitely “Pure opening transluminal endoscopic functions (NOTES) was a surfacing field contained in this intestinal operations and you may interventional gastroenterology into the that the doctor accesses the fresh peritoneal hole thru a hollow viscus and you may performs diagnostic and healing methods … Discover more that needs to be read about so it process, such as the risk of peritoneal contamination. At this point, the fresh available looks off scientific experience cannot have shown deleterious consequences regarding contamination and you can after that disease. At the moment, Notes however should be considered mainly experimental and may be performed simply inside a research form”.
Candy Cane Syndrome (Roux Problem)
Sweets cane syndrome (CCS), coincidentally labeled as Roux problem or Candy cane Roux syndrome, is actually a rare side effect into the people just after Roux-en-Y gastric sidestep procedures. It occurs when there is a too high period of roux limb proximal in order to gastrojejunostomy, undertaking the option to have dining dirt in order to resort and stay into the the fresh new blind redundant limb.
All of the got pre-medical functions-as much as choose CCS
Aryaie and colleagues (2017) noted that CCS has been implicated as a cause of abdominal pain, nausea, and emesis after RYGB; however, it remains poorly described. These investigators reported that CCS is real and can be treated effectively with revisional bariatric surgery. All patients who underwent resection of the “Candy cane” between were included in this study. Demographic data; pre-, peri-, and post-operative symptoms; data regarding hospitalization; and post-operative weight loss were examined via retrospective chart review. Data were analyzed using Student’s t test and ?2 analysis where appropriate. A total of 19 patients had resection of the “Candy cane” (94 % women, mean age of 50 ± 11 years), within 3 to 11 years after initial RYGB. Primary presenting symptoms were epigastric abdominal pain (68 %) and nausea/vomiting (32 %), especially with fibrous foods and meats. On upper gastro-intestinal (GI) study and endoscopy, the afferent blind limb was the most direct outlet from the gastrojejunostomy. Only patients with these pre-operative findings were deemed to have CCS; 18 (94 %) cases were completed laparoscopically. Length of the “Candy cane” ranged from 3 to 22 cm; median length of stay was 1 day. After resection, 18 (94 %) patients had complete resolution of their symptoms (p < 0.001). Mean BMI decreased from 33.9 ± 6.1 kg/m2 pre-operatively to 31.7 ± 5.6 kg/m2 at 6 months (17.4 % EWL) and 30.5 ± 6.9 kg/m2 at 1 year (25.7 % EWL). The average length of latest follow-up was 20.7 months. The authors concluded that CCS is a real phenomenon that could be managed safely with excellent outcomes with resection of the blind afferent limb. A thorough diagnostic work-up is critical for proper identification of CCS; and surgeons should minimize the size of the blind afferent loop left at the time of initial RYGB.