Erridge and you can acquaintances (2016) described the fresh scientific apps out of sheer orifice transluminal endoscopic procedures (NOTES) within the bariatric functions

Erridge and you can acquaintances (2016) described the fresh scientific apps out of sheer orifice transluminal endoscopic procedures (NOTES) within the bariatric functions

These types of detectives achieved a look at studies, up to off techniques and you will results of bariatric Cards strategies. A total of nine courses were within the final studies, with other 6 files outlining endolumenal methods provided getting analysis. The Cards knowledge adopted a crossbreed process. Crossbreed Cards case gastrectomy (hNSG) is actually discussed within the 4 humans and you can 2 porcine knowledge. Inside the humans, 6 sufferers (23.1 %) was in fact converted to old-fashioned laparoscopic tips, and step 1 post-medical side-effect (step 3.8 %) is actually stated. Mean extra weight loss is 46.six % (listing of thirty five.dos to 58.9). New article authors figured transvaginal-aided arm gastrectomy searched possible and secure when did from the appropriately instructed benefits. But not, they reported that advancements need to be designed to overcome most recent technology restrictions.

An UpToDate feedback to the “Natural orifice transluminal endoscopic businesses (NOTES)” (Pasricha and you will Rivas, 2018) says one to “Pure beginning transluminal endoscopic functions (NOTES) try an appearing field within dominican cupid this intestinal businesses and interventional gastroenterology when you look at the that doctor accesses brand new peritoneal hole thru a hollow viscus and you can functions diagnostic and you can therapeutic strategies … There was alot more that needs to be read about which techniques, for instance the threat of peritoneal contamination. To date, the new available muscles off scientific experience will not demonstrated deleterious consequences about contaminants and subsequent infection. At present, Notes nonetheless should be thought about generally fresh and must be achieved just from inside the a report form”.

Sweets Cane Syndrome (Roux Problem)

Chocolate cane syndrome (CCS), and this is also known as Roux problem otherwise Sweets cane Roux disorder, is a rare side-effect from inside the people immediately after Roux-en-Y gastric bypass operations. It occurs if you have an excessive amount of roux limb proximal so you can gastrojejunostomy, starting the possibility to possess dining dirt in order to hotel and remain when you look at the the fresh new blind redundant limb.

Most of the got pre-surgical performs-doing select CCS

Aryaie and colleagues (2017) noted that CCS has been implicated as a cause of abdominal pain, nausea, and emesis after RYGB; however, it remains poorly described. These investigators reported that CCS is real and can be treated effectively with revisional bariatric surgery. All patients who underwent resection of the “Candy cane” between were included in this study. Demographic data; pre-, peri-, and post-operative symptoms; data regarding hospitalization; and post-operative weight loss were examined via retrospective chart review. Data were analyzed using Student’s t test and ?2 analysis where appropriate. A total of 19 patients had resection of the “Candy cane” (94 % women, mean age of 50 ± 11 years), within 3 to 11 years after initial RYGB. Primary presenting symptoms were epigastric abdominal pain (68 %) and nausea/vomiting (32 %), especially with fibrous foods and meats. On upper gastro-intestinal (GI) study and endoscopy, the afferent blind limb was the most direct outlet from the gastrojejunostomy. Only patients with these pre-operative findings were deemed to have CCS; 18 (94 %) cases were completed laparoscopically. Length of the “Candy cane” ranged from 3 to 22 cm; median length of stay was 1 day. After resection, 18 (94 %) patients had complete resolution of their symptoms (p < 0.001). Mean BMI decreased from 33.9 ± 6.1 kg/m2 pre-operatively to 31.7 ± 5.6 kg/m2 at 6 months (17.4 % EWL) and 30.5 ± 6.9 kg/m2 at 1 year (25.7 % EWL). The average length of latest follow-up was 20.7 months. The authors concluded that CCS is a real phenomenon that could be managed safely with excellent outcomes with resection of the blind afferent limb. A thorough diagnostic work-up is critical for proper identification of CCS; and surgeons should minimize the size of the blind afferent loop left at the time of initial RYGB.