Bariatric Times - Supplement A - Covidien - (Page 12)

THE 2007 INTERNATIONAL CONSENSUS SUMMIT ON SLEEVE GASTRECTOMY This strategy results in a significant reduction of operative risk while maintaining the ability to complete all operations laparoscopically, sparing these patients the risk of potential complications associated with open surgery. percent were American Society of Anesthesiologists (ASA) physical status score III and 52 percent were ASA physical status score IV. The mean number of comorbid conditions per patient was 9.3±0.3 with a median of 10 (range 3–17). There was one distant mortality, and the incidence of major complications was 13 percent. Mean excess weight after LSG at one year was 46 percent. The mean time interval between the first and second stages was 12.6±0.8 months. Thirty-six patients with a mean BMI of 49.1±1.3 (excess weight loss [EWL]=38%) had the second-stage LRYGBP. The mean number of comorbidities in this group was 6.4±0.1 (reduced from 9). The ASA class of the majority of patients had been downstaged at the time of LRYGB. The mean and median hospital stays were 3±1.7 and 2.5 (range 2–7) days, respectively. There were no deaths, and the incidence of major complications was eight percent. CONCLUSION The staging concept of LSG followed by LRYGBP is a safe and effective surgical approach for highrisk patients seeking bariatric surgery. This strategy results in a significant reduction of operative risk while maintaining the ability to complete all operations laparoscopically, sparing these patients the risk of potential complications associated with open surgery. KEY POINTS • The two-stage approach studied here was a first-stage LSG and a second-stage laparoscopic Roux-en-Y gastric bypass. • LSG is associated with fewer surgical maneuvers and no anastomoses, and was therefore considered a suitable selection as a preliminary stage. • The gastrectomies were performed by longitudinally resecting at least two-thirds of the stomach, with the line of resection that initiated at the antrum at a point that was 5cm proximal to the pylorus, and extended towards the angle of His. • Patients were considered eligible for stage II (LRYGB) after at least six months or after a weight loss of greater than 100 pounds and significant risk reduction. • The staging concept of LSG followed by LRYGBP is a safe and effective surgical approach for high-risk patients seeking bariatric surgery. 12 Bariatric Times [ J U N E 2008, SUPPLEMENT A]

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Bariatric Times - Supplement A - Covidien Contents Laparoscopic Sleeve Gastrectomy: From Magenstrasse And Mill To Sleeve Sleeve Gastrectomy Provides Resoultion of Type-2 Diabetes Without Duodenal Exclusion The Relationship Bewtween The Resected Remnant And Weight Loss Laparoscopic Sleeve Gastrectomy: Results After Two And Five Years Laparoscopic Sleeve Gastrectomy As An Initial Weight Loss Procedure For High-Risk Patients With Morbid Obesity Three-Year Results Of Laparoscopic Sleeve Gastrectomy In The Treatment Of Morbid Obesity In Korea Laparoscopic Sleeve Gastrectomy: Nutritional Concerns And PostOperative Dietary Care Laparoscopic Sleeve Gastrectomy: Prevention And Treatment Of Bleeding Prevention And Treatment Of Gerd/Hiatal Hernia And Stenosis Associated With Sleeve Gastrectomy Laparoscopic Revisions Of Sleeve Gastrectomy Survey Results

Bariatric Times - Supplement A - Covidien

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