Abstract:LVBG offers a good alternative to the standard open VBG. Although this procedure has a relatively short learning curve, it should be done at centers with an interest in bariatric surgery.
The clinical effects of laparoscopy in the pulmonary function of obese patients have been poorly investigated in the past. A systematic review was undertaken, with the objective to identify published evidence on pulmonary complications in laparoscopic surgery in the obese. Outcome measures included pulmonary morbidity, pulmonary infection and mortality. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) with 95% confidence interval (CI). A total of 6 randomized and 14 observational studies were included, which reported data on 185,328 patients. Pulmonary complications occurred in 1.6% of laparoscopic and in 3.6% of open procedures (OR 0.45, 95% CI 0.34-0.60). Pneumonia was reported in 0.5% and in 1.1%, respectively (OR 0.45, 95% CI 0.40-0.51). Available evidence suggests lower pulmonary morbidity for laparoscopic surgery in obese patients; further quality studies are however necessary to consolidate these findings.
The clinical effects of laparoscopy in the pulmonary function of obese patients have been poorly investigated in the past. A systematic review was undertaken, with the objective to identify published evidence on pulmonary complications in laparoscopic surgery in the obese. Outcome measures included pulmonary morbidity, pulmonary infection and mortality. The random effects model was used to calculate combined overall effect sizes of pooled data. Data are presented as the odds ratio (OR) with 95% confidence interval (CI). A total of 6 randomized and 14 observational studies were included, which reported data on 185,328 patients. Pulmonary complications occurred in 1.6% of laparoscopic and in 3.6% of open procedures (OR 0.45, 95% CI 0.34-0.60). Pneumonia was reported in 0.5% and in 1.1%, respectively (OR 0.45, 95% CI 0.40-0.51). Available evidence suggests lower pulmonary morbidity for laparoscopic surgery in obese patients; further quality studies are however necessary to consolidate these findings.
“…The experience with the HALS vertical banded gastroplasty vs open surgery is presented in this issue by Bleier et al [2], This article indicates that the HALS approach is a viable alternative to the standard open approach. The readers of the articles on hand-assisted surgery in the October and November issues of Surgical Endoscopy will appreciate the broad spectrum of applications for the HALS approach.…”
Section: Will Advanced Laparoscopic Surgery Go Hand-assisted?mentioning
“…Die innere Hand oder ¹Endo-Handª führt zu einem sicheren atraumatischen Gewebezug, Exposition und Darstellung der relevanten Anatomie. Die ¹Endo-Handª kann zum Fassen von Organen wie dem Colon oder Omentum majus oder auch zur sofortigen Kontrolle einer Blutung während gr öûerer Operationen eingesetzt werden [3,6,7,12,21] [6,7]. Es gibt einige ergonomische Überlegungen zum Einsatz der ¹Endo-Handª ungeachtet ihrer Durchführbarkeit.…”
Section: Apparate Und Instrumente Für Die ¹Endo-handªunclassified
The technology associated with endoscopic surgery continues to evolve as a result of industrial R & D and research within academic surgical departments with interest in surgical endoscopic and remote handling technology. Some of the developments in the last ten years are reviewed. The problem concerning health technology assessment (HTA) in relation to new devices/instrumentation and procedures is discussed. Randomised controlled clinical trials are unsuited for the initial HTA of technology-dependent interventions, and for this reason, an alternative system, controlled stepwise evaluation (CSE) is proposed.
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