The Role of Relaparoscopy in the Management of Early Bariatric Surgery Complications and 30-Day Outcome: a Tertiary Centre Experience

Al-Rashedy, Mohammed; Ghosh, Anirban; Mukherjee, Tanmoy; Halai, Sonal; Mahmood, Ruba A; Krivan, Sylvia; Munasinghe, Aruna; Rashid, Farhan; Al-Taan, Omer

doi:10.1007/s11695-021-05401-1

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…15 17 Therefore, signs and symptoms of leakage, including a drop in hemoglobin levels, hematochezia, hematemesis, or melena, should be considered for further evaluations. 18 19 On the other side, endoscopy is often performed as a routine diagnostic method to investigate of the leakage source. 17 However, surgical re-exploration may be required in severe postoperative bleeding cases and when hemodynamic instability is possible in subjects.…”

Section: Discussionmentioning

confidence: 99%

“…11 Moreover, some researchers believe that leaks are linked to significant morbidity and mortality rates. 19,25 The overall incidence of an anastomotic leak following bariatric surgery is reported as approximately 2.4% among SG patients. 26 As surgeon experience with the laparoscopic approach increases, the rate of anastomotic leakage is often declined.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

Goudarzi¹,

Obney

Hemmatizadeh³

et al. 2022

Journal of Digestive Endoscopy

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Introduction Endoscopic treatments have become popular by providing the best solution for healing complications while allowing oral nutrition. In this study, we aim to evaluate outcomes of the endoscopic-covered stents for staple line complications following bariatric surgery. Methods A prospective evaluation was performed for all patients treated for staple line complications after bariatric surgery. Bariatric patients with acute leaks, chronic gastrocutaneous fistulas, and anastomotic strictures refractory to endoscopic dilation after sleeve gastrectomy were included in this survey. Results From January 2019 to June 2020, 41 patients (12 with acute leaks, 16 with chronic fistulas, and 13 with strictures) were treated with endoscopic silicone-covered stents (polyester or nitinol). The mean follow-up was 3.5 months. Immediate symptomatic improvement occurred in 95.2% (91.7% of acute leaks, 81.2% of fistulas, and 92.3% of strictures). In addition, 87.8% of patients initiated oral feeding immediately after stenting. There was no mortality case in this population. Conclusion Although stent migration rarely occurs in subjects, the endoscopic silicone-covered stents strategy is one of the best treatments for anastomotic complications after bariatric surgery, providing rapid healing while simultaneously allowing for oral nutrition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

Goudarzi¹,

Obney

Hemmatizadeh³

et al. 2022

Journal of Digestive Endoscopy

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“…As assessed in the recent review from Halkias et al [24] a key role is played by surgeons' expertise; pooling data from 17 articles dated from 2007 to 2020, the authors concluded that re-operative laparoscopic colorectal surgery is safe when performed by experienced hands. Similarly, Al-Rashedy and colleagues [25], focusing on the role of re-laparoscopy in the management of early bariatric surgery complications, described the importance of the surgeon's experience in choosing laparoscopy as reoperative approach. Re-laparoscopy may allow to maintain the benefits of a minimally invasive approach also in the setting of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Relaparoscopy in the management of post-operative complications after minimally invasive gastrectomy for gastric cancer

et al. 2022

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Laparoscopy has already been validated for treatment of early gastric cancer. Despite that, no data have been published about the possibility of a minimally invasive approach to surgical complications after primary laparoscopic surgery. In this multicentre study, we describe our experience in the management of complications following laparoscopic gastrectomy for gastric cancer. A chart review has been performed over data from 781 patients who underwent elective gastrectomy for gastric cancer between January 1996 and July 2020 in two high referral department of gastric surgery. A fully descriptive analysis was performed, considering all the demographic characteristics of patients, the type of primary procedure and the type of complication which required reoperation. Moreover, a logistic regression was designed to investigate if either the patients or the primary surgery characteristics could affect conversion rate during relaparoscopy. Fifty-one patients underwent reintervention after elective laparoscopic gastric surgery. Among patients who received a laparoscopic reintervention, 11 patients (34.3%) required a conversion to open surgery. Recovery outcomes were significantly better in patients who completed the reoperation through laparoscopy. Relaparoscopy is safe and effective for management of complications following laparoscopic gastric surgery and represent a useful tool both for re-exploration and treatment, in expert and skilled hands.

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“…In this study, seven patients required an additional laparoscopy due to leakage (5 cases), twisting (1 case), or bleeding at the staple line (1 case). All laparoscopic operations were completed safely [26]. Another study of 1860 LSG patients showed that 20 (1.1%) experienced post-LSG hemorrhaging and 11 required reoperation (0.6%) [9].…”

Section: Comparison Of the Omentopexy And Control Groupsmentioning

confidence: 97%

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

Kara,

Ozel,

Yardimci

2024

OBES SURG

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Background Laparoscopic sleeve gastrectomy (LSG) is a commonly performed type of bariatric surgery. Early complications of LSG include bleeding, leakage, pulmonary embolism, and surgical site infections. Most surgeons try to implement preventive methods, such as omentopexy. Staple line-imbrication, which has a difficult learning curve, often prevents complications. This study aimed to evaluate the effect of omentopexy on patients with imbricated LSG. Material and Methods The study applied a retrospective data analysis design to patients who underwent LSG between 2020 and 2023. All patients’ staple lines were imbricated, and patients were then divided into two groups: omentopexy group and control group. Patients’ demographic features, such as age, gender, height, weight, body mass index(BMI), bleeding, leakage, and reoperations, were recorded and examined retrospectively. Results A total of 1356 patients were included in the study (540 in omentopexy, 816 in control), of which the mean age was 37.9 ± 10.5 years, 82.3% were women, and mean BMI was 40.9 ± 5.8 kg/m2. The mean bleeding rate was 1.0% (1.3–0.7%), the mean leakage rate was 0.2% (0.2–0.2%, respectively), and the mean reoperation rate was 0.6% (0.7% and 0.5%, respectively). No statistically significant differences were observed. Conclusion Omentopexy is a technique that is widely used to prevent staple line complications. According to our study, omentopexy applied to an imbricated stapler line increased the operation time but did not affect bleeding or leakage ratios. This is the first study to evaluate the effect of omentopexy on imbricated staple lines. The findings of the study indicate that omentopexy has no additional benefit on early complications when using staple-line imbrication. Graphical Abstract

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The Role of Relaparoscopy in the Management of Early Bariatric Surgery Complications and 30-Day Outcome: a Tertiary Centre Experience

Cited by 5 publications

References 15 publications

Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

Endoscopic Self-Expanding Metallic Stent Placement in the Management of Post Laparoscopic Sleeve Gastrectomy Complications

Relaparoscopy in the management of post-operative complications after minimally invasive gastrectomy for gastric cancer

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

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