Alarming Trends Regarding Laparoscopic Sleeve Gastrectomy

Clapp, Benjamin; Martyn, Colin; Wynn, Matthew; Foster, Chase H.; Ricci, C.; Tyroch, Alan; O’Dell, Montana

doi:10.1016/j.soard.2017.09.008

Cited by 4 publications

(2 citation statements)

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“…Performing bariatric surgery prior to kidney transplant 25,26,40‐46 is a strategy which has been gaining popularity with the introduction of minimally invasive techniques and recent reports have demonstrated acceptable morbidity and mortality 24,47 The main disadvantage of this approach is that patients wait longer for a kidney transplant with increased morbidity and mortality while on dialysis 35 . By performing the sleeve gastrectomy simultaneously with kidney transplant, the patient can be transplanted sooner with only one procedure requiring general anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous robotic kidney transplantation and bariatric surgery for morbidly obese patients with end-stage renal failure

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Tulla

et al. 2021

American Journal of Transplantation

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Patients with obesity have limited access to kidney transplantation, mainly due to an increased incidence of surgical complications, which could be reduced with selective use of robotic‐assisted surgery. This prospective randomized controlled trial compares the safety and efficacy of combining robotic sleeve gastrectomy and robotic‐assisted kidney transplant to robotic kidney transplant alone in candidates with class II or III obesity. Twenty candidates were recruited, 11 were randomized to the robotic sleeve gastrectomy and robotic‐assisted kidney transplant group and 9 to the robotic kidney transplant group. At 12‐month follow‐up, change in body mass index was –8.76 ± 1.82 in the robotic sleeve gastrectomy and robotic‐assisted kidney transplant group compared to 1.70 ± 2.30 in the robotic kidney transplant group (P = .0041). Estimated glomerular filtration rate, serum creatinine, readmission rates, and graft failure rates up to 12 months were not different between the two groups. Length of surgery was longer in the robotic sleeve gastrectomy and robotic‐assisted kidney transplant group (405 minutes vs. 269 minutes, p = .00304) without increase in estimated blood loss (120 ml vs. 117 ml, p = .908) or incidence of surgical complications. Combined robotic‐assisted kidney transplant and sleeve gastrectomy is safe and effective compared to robotic‐assisted kidney transplant alone.

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Section: Discussionmentioning

confidence: 99%

Simultaneous robotic kidney transplantation and bariatric surgery for morbidly obese patients with end-stage renal failure

Spaggiari

Cocco

Tulla

et al. 2021

American Journal of Transplantation

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“…In a recent analysis on the ESRD population, Choudhury et al [110], using a probabilistic Markov model, conclude that RYGB improves access to renal transplantation and thereby increases long-term survival. However, at present, the preferred approach is LSG [110][111][112][113][114]. LSG offers several advantages over RYGB [116].…”

Section: Pretransplantmentioning

confidence: 99%

Obesity in kidney transplantation

et al. 2019

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The prevalence of obesity among patients with chronic kidney disease continues to increase as a reflection of the trend observed in the general population. Factors affecting the access to the waiting list and the transplantability of this specific population will be analysed. From observational studies, kidney transplantation in obese patients carries an increased risk of surgical complications compared to the nonobese population; therefore, many centres have been reluctant to proceed with transplantation, despite this treatment modality confers a survival advantage over dialysis. As a consequence, obese patients continue to face decreased access to the waiting list, with a lower likelihood of being transplanted and higher waiting times when compared to the nonobese candidates. In this review will be described the current strategies for treatment of obesity in different settings (pretransplant, at transplant and post-transplant). Obesity represents a risk factor for surgical complications but not a contraindication for kidney transplantation; outcomes could be greatly improved with its multidisciplinary and multimodal treatment. The modern technology with minimally invasive techniques, mainly using robotic platform, allows a reduction in the surgical complications rate, with graft and patient survival rates comparable to the nonobese counterpart.

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