Liakópulos N, Pérez VR, Vargas R

Language: Spanish
References: 11
Page: 114-116
PDF size: 28.83 Kb.

ABSTRACT

Introduction: Analyzes the experience on the initial use of the Adjustable Gastric Band (Lap-Band) by laparoscopic technique for the treatment of morbid obesity. Patients and methods: Realized a protocol which included sixty one morbid obese patients operated between the months of February 2000 and October 2001. Patients with an initial mean weight of 124 kg (range, 81-245 kg), a mean Body Mass Index (BMI) of 44 (range, 36-70), and an average age of 38 years (range, 18-60). Co-morbilities were present in 35 of the patients, been the most frequent: hypertension, sleep apnea, arthropathy and diabetes mellitus. Results: Post-operative controls were established at the first, third, six and twelve month respectively. Other surgeries were realized in five of the patients within the same surgical time: four cholecystectomy and one umbilical herniorrhaphy. In one of the cases reconversion was needed due to the presence of an important hypercapnea. Two reinterventions were necessary, one due to intra-abdominal bleeding from one of the portals and the other due to an early slippage of the band. The first adjustment of the band was realized after six weeks of the operation, patients showed a decrease in the percentage of their average weight of 10 kg by that time Conclusion: Low morbi-mortality, minimum access surgery, short hospitalary stay and reversibility make this technique one of the most important alternatives for the bariatric surgeon. Co-morbilities such as, sleep apnea, diabetes, and hypertension improved significally making a much better quality of life for each and everyone of the patients.

REFERENCES

1. Kuzmak L. Silicone gastric banding: a simple and effective operation for morbid obesity. Contemp Surg 1986; 28: 13-18.

2. Belachew MJ, Legrand TH, Defedrereux MP, Burtheret N. Laparoscopic adjustable silicone gastric banding in the treatment of morbid obesity. Surg Endosc 1994; 81: 354-1,356.

3. Cadière GB, Bruyns J, Himpens J, Favretti F. Laparoscopic gastroplasty for morbid obesity. Br J Surg 1994; 81: 1, 524.

4. Mason EE. Vertical banded gastroplasty for obesity. Arch Surg 1982; 117: 701-706.

5. Baltasar A, del Río J, Bengochea M, Escrivá C, Bou R, Miró J et al. Cirugía híbrida bariátrica: “cruce duodenal” en la derivación biliopancreática. Cir Esp 1996; 59: 483-486.

6. Sánchez-Cabezudo C, Larrad Jiménez A, Ramos García I, Moreno Esteban B. Resultado a 5 años de la derivación biliopancreática de Larrad en el tratamiento de la obesidad mórbida. Cir Esp 2001; 70: 133-141.

7. Alastrué A, Rull M, Casas D, Moreno P, Formiguera X, Gratacós M et al. Evaluación de dos técnicas restrictivas en cirugía bariátrica: Gastroplastia vertical anillada frente a bandeleta gástrica hinchable. Valoración de dos años. Cir Esp 1996; 60: 181-187.

8. Pories WJ, McDonald KG Jr, Morgan EJ et al. Surgical treatment of obesity and its effect on diabetes: 10 year follow-up. Am J Clin Nutr 1992; (suppl 2): 582-585.

9. Yale CE. Gastric surgery for morbid obesity. Complications and long-term weight control. Arch Surg 1989; 124: 941-946.

10. Benotti PN, Forse RA. The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg 1995; 169: 361-367.

11. Kellum JM, DeMAría EJ, Sugerman HJ. The surgical treatment of morbid obesity. Curr Prob Surg 1998; 35: 796-851.