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Obesity Surgery March 2014 issue: the highlights

The March issue of Obesity Surgery (Volume 24, Issue 3,), the official journal of the International Federation for the Surgery of Obesity and Metabolic Disorders, is now available online. Here are some of the highlights from this issue:

Vitamin D Status 10 Years After Primary Gastric Bypass: Gravely High Prevalence of Hypovitaminosis D and Raised PTH Levels.

The aim of this study was to evaluate the prevalence of vitamin D deficiency and secondary hyperparathyroidism after RYGB in 293 patients. The researchers found that Vitamin D was inversely correlated with PTH levels and positively correlated with calcium. They concluded that the data was “alarming” and highlighted the need for improved long-term follow-up...(Abstract)

Hiatal Hernia Repair in Laparoscopic Adjustable Gastric Banding and Laparoscopic Roux-En-Y Gastric Bypass: A National Database Analysis.

The investigators wanted to assess the surgical risk of hiatal hernia repairs performed concomitantly with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) to decrease gastro-oesophageal reflux disease (GERD). They used the US Nationwide Inpatient Sample 2004–2009 to compare mortality risk, prolonged length of stay (PLOS), and perioperative adverse events using propensity score-matched analysis. They found no evidence of increased risk of perioperative adverse events among patients undergoing concomitant HH repair with LRYGB or LAGB...(Abstract)

Fast Track Care for Gastric Bypass Patients Decreases Length of Stay Without Increasing Complications in an Unselected Patient Cohort.

The researchers from this study evaluated the implementation of fast track care in unselected bariatric patients in a high volume teaching hospital in the Netherlands. They compared 104 patients who underwent a primary laparoscopic gastric bypass before fast track care, against 360 patients who had the procedure after implementation. The report the length of stay, perioperative times, complications (<30 days), readmissions and prolonged length of stay were secondary outcomes. They conclude that fast track does enhance recovery and is suitable for unselected patients...(Abstract)

Clinical Experience with a Port-Free Internal Liver Retractor in Laparoscopic Bariatric Surgery.

Study researchers present their experience with a port-free internal liver retractor, the Endolift, used in 31 Roux-en-Y gastric bypasses and two single-incision sleeve gastrectomies. They report the technique, mean operative time, placement of the device and device-related complications...(Abstract)

Residual Gastric Volume Estimated with a New Radiological Volumetric Model: Relationship with Weight Loss After Laparoscopic Sleeve Gastrectomy.

The volume of the gastric reservoir appears crucial when  explaining the  success of LSG  and this study sought to describe a new, easy model to estimate gastric reservoir volume after LSG; to evaluate the volumetric changes 1 year after surgery; and to analyse their relationship with weight loss. The gastric reservoir was evaluated radiologically considering the image as a complex geometrical shape with two components: a cylinder (gastric body) and a truncated cone (antrum). The investigators concluded that this is an easy volumetric model to estimate the size of the gastric reservoir after LSG and a direct relationship between an increase in gastric reservoir volume and a lower weight loss after surgery was seen...(Abstract)