Research and education are foundational to the mission of Bayfront Health and our Weight Loss and Bariatric Surgery Institute. Our physicians share their research and clinical insights with a national and international community of colleagues.
|Management of Malnutrition and Hepatic Impairment After Duodenal Switch
|CONCLUSIONS: While refractory malnutrition and/or liver failure are rare among patients post-DS, if underdiagnosed and untreated, this can lead to irreversible outcomes and death. All revisional procedures included in this study resulted in improvement of the nutritional status and reversal of liver...
|Comparative multicenter analysis of sleeve gastrectomy, gastric bypass, and duodenal switch in patients with BMI 70kgmsup2sup a 2-year follow-up
|Patients undergoing metabolic and bariatric surgery (MBS) with body mass index (BMI) ≥ 70 kg/m² are considered a high-risk group. There is limited literature to guide surgeons on the perioperative safety as well as the different procedural outcomes of MBS in this cohort. Our aim is to compare the sa...
|Marginal Ulcer and Dumping Syndrome in Patients after Duodenal Switch A Multi-Centered Study
|CONCLUSIONS: The incidences of MU and dumping after DS were low. NSAID use and a longer operation time were associated with an increased risk of MU, whereas dumping was attributed to poor dietary habits.
|Long-Term Outcomes of Sleeve Gastrectomy Weight Recurrence and Surgical Non-responders
|CONCLUSIONS: Only 20% of patients who underwent SG and followed up for more than 5 years were able to maintain appropriate weight loss.
|Analysis of the Impact of the Learning Curve on the Safety Outcome of the Totally Robotic-Assisted Biliopancreatic Diversion with Duodenal Switch a Single-Institution Observational Study
|CONCLUSIONS: After the first 50 cases, the operative time, the length of stay, and the overall rate of complications decreased, being especially significant the decrease in the duodeno-ileal anastomosis leakage rate after reaching the learning curve.
|Implementing novel modalities into an institutional enhanced recovery after bariatric surgery ERABS protocol
|CONCLUSION: Focus on optimized pain management, allied to a superior PONV control, may be relevant contributors for a lower LOS without negative impacts in complications rates.
|Impact of Emend on Perioperative Bariatric Surgery Antiemetic Utilization, Patient Satisfaction, and Costs
|CONCLUSION: Fosaprepitant is a relevant alternative in preventing and treating PONV in patients who underwent bariatric/metabolic surgical procedures.
|Impact of Perioperative Ketamine on Postoperative Bariatric Surgery Opioid Use and Length of Stay
|CONCLUSIONS: Ketamine may be a feasible alternative to reduce opioid use and hospital length of stay. We believe that ketamine can be an important contribution to ERABS pathways, being responsible for improved outcomes after bariatric/metabolic surgical procedures.
|Impact on Mid-Term Health-Related Quality of Life after Duodenal Switch a Systematic Review and Meta-Analysis
|CONCLUSION: Our meta-analysis demonstrated an improvement in mid-term HrQoL after BPD-DS. Despite the promising trends demonstrated in this meta-analysis, further studies with large sample sizes are needed to evaluate the impact of HrQoL on patients with obesity after BPD-DS.
|Sleeve-Dor Fundoplication - An Innovative Surgical Technique to Avoid the Epidemic Long Term de Novo Gastroesophageal Reflux and Barretts Esophagus After Sleeve Gastrectomy for Obesity
|BACKGROUND: Sleeve gastrectomy (SG) in current literature showed an increased risk of "de novo" gastroesophageal reflux disease (GERD) and increased risk for Barrett's esophagus in longer follow-up series, with a possibility of esophageal adenocarcinoma in this population. Adding primarily an anteri...
|Robot-assisted duodenal switch with DaVinci Xi surgical technique and analysis of a single-institution experience of 661 cases
|Metabolic and bariatric surgery is an effective treatment for the management of obesity and related comorbidities. Although the duodenal switch has demonstrated superior results in terms of resolution of obesity-related comorbidities and weight loss, it is one of the less performed procedures. The u...
|Single- Versus Double-Anastomosis Duodenal Switch Outcomes Stratified by Preoperative BMI
|CONCLUSION: BPD-DS achieved greater %TBWL at 2 years, but no superiority was perceived among study subgroups. SADI-S and BPD-DS showed similar overall complication rates.
|Duodenal Switch Conversion in Non-responders or Weight Recurrence Patients
|CONCLUSION: Duodenal switch conversions are an effective salvage procedure for insufficient weight loss and/or weight regain after adjustable gastric band, sleeve gastrectomy, and Roux-en-Y gastric bypass; it is also safe, associated to low readmission, reoperation, and mortality rates.
|Endoscopic sleeve gastroplasty for treatment of class 1 and 2 obesity MERIT a prospective, multicentre, randomised trial
|BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is an endolumenal, organ-sparing therapy for obesity, with wide global adoption. We aimed to explore the efficacy and safety of ESG with lifestyle modifications compared with lifestyle modifications alone.
|Analysis of the sharpening effect in gyromagnetic nonlinear transmission lines using the unidimensional form of the Landau-Lifshitz-Gilbert equation
|Continuous nonlinear transmission lines (NLTLs), also known as gyromagnetic lines, consist of ferrite-based magnetic cores biased by an external magnetic field. Over the past years, many analytical and experimental studies have predicted the rise time reduction of the input pulse to the range of a f...
|ANTI-REFLUX PROCEDURES AFTER ROUX-EN-Y GASTRIC BYPASS
|CONCLUSIONS: Female patients with a significant weight loss may develop a severe reflux symptoms years after RYGB. Complaints of reflux after RYGB should not be overlooked. Careful follow-up and appropriate treatment (including surgical intervention) is needed for this population.
|Hydatid cyst in the neck, an unusual localization of the disease A case report
|CONCLUSION: Hydatid cyst disease in the neck is extremely rare. Hydatid cyst should be included in differential diagnosis of cystic lesions in the neck especially in patients from endemic countries. Post-operative surveillance is important to diagnose the complete healing or recurrence of hydatid di...
|To oversew or not to oversew in robotic sleeve gastrectomy a case against oversewing the staple line
|CONCLUSIONS: No significant difference in major complications was found between RSG patients with and without oversewn staple lines. Oversewing of the staple line may be associated with increased emergency room visits.
|Brazilian Consensus on Endoscopic Sleeve Gastroplasty
|CONCLUSIONS: This consensus establishes practical guidelines for performance of ESG. The experience of 1828 procedures shows the expertise of the selected specialists participating in this consensus statement. The group's experience has a satisfactory weight loss with low adverse events rate. The ma...
|Cardiopexy at the Time of Sleeve Gastrectomy as a Preventive Measure for Reflux
|CONCLUSION: Cardiopexy was not associated with a reduced rate of symptomatic GERD and conversion to RYGB after 6 months.
|Feasibility and safety of robot-assisted bariatric conversions and revisions
|CONCLUSIONS: Robot-assisted conversions and revisions were as feasible and safe as laparoscopic procedures. However, operative time was longer in robot-assisted conversions.
|Short-term results of long biliopancreatic limb Roux-en-Y gastric bypass-is it superior
|CONCLUSIONS: Short-term results show that long biliopancreatic limb RYGB was not associated with a more significant weight loss after RYGB. The 2 procedures were similar in 30-day complications.
|Conversions of Roux-en-Y gastric bypass to duodenal switch SADI-S and BPD-DS for weight regain
|CONCLUSION: Conversions of RYGB to SADI-S and BPD-DS can provide significant additional weight loss. However, complications and malnutrition can develop after the conversion, and further research is needed for evaluating safety.
|Safety and short-term effectiveness of endoscopic sleeve gastroplasty using overstitch preliminary report from a multicenter study
|CONCLUSION: Short-term results suggest that ESG is a safe and effective option for patients with Class I and II obesity.
|Pathologic findings of the removed stomach during sleeve gastrectomy
|CONCLUSION: Patients with gastroesophageal reflux and hyperlipidemia might suggest higher incidence rate of gastric histopathologic abnormalities. Routine preoperative screening may not be beneficial for patients undergoing sleeve gastrectomy.
|Preoperative Transversus Abdominis Plane TAP Block with Liposomal Bupivacaine for Bariatric Patients to Reduce the Use of Opioid Analgesics
|CONCLUSION: The use of preoperative TAP block with liposomal bupivacaine significantly decreased the use of IV and oral opioid analgesics. A larger prospective study may be needed to further validate the results.
|Negative cross-resistance between structurally different Bacillus thuringiensis toxins may favor resistance management of soybean looper in transgenic Bt cultivars
|High adoption rates of single-gene Bacillus thuringiensis (Bt) Cry1Ac soybean impose selection pressure for resistance in the soybean looper, Chrysodeixis includens, a major defoliator in soybean and cotton crops. To anticipate and characterize resistance profiles that can evolve, soybean looper lar...
|Safety and effectiveness of single- versus double-anastomosis duodenal switch at a single institution
|CONCLUSIONS: SADI-S and double-anastomosis DS are comparable in terms of weight loss and complication rate. However, close nutritional follow-up is warranted for both procedures.
|Conversions After Sleeve Gastrectomy for Weight Regain to Single and Double Anastomosis Duodenal Switch and Gastric Bypass at a Single Institution
|CONCLUSION: Conversions of LSG to RYGB, double anastomosis DS, and SADI-S are safe and can provide significant additional weight loss.
|Management of Bariatric Complications Using Endoscopic Stents a Multi-Center Study
|CONCLUSION: Stents may be useful and effective in managing complications after different bariatric procedures, including RYGB and LSG.
|Efficacy of Utilizing Argon Plasma Coagulation for Weight Regain in Roux-en-Y Gastric Bypass Patients a Multi-center Study
|CONCLUSION: APC can be useful in reducing the regained weight after RYGB, and patients showed 6-10% total weight loss at 12 months. Randomized trials would be needed to validate the findings.
|Cirrhosis following single anastomosis duodeno-ileal switch A case report
|CONCLUSION: Close laboratory monitoring is important after SADI-S in order to detect worsening hepatic dysfunction, which may occur many years after the surgery in the absence of other etiologies for liver failure.
|Safety and Effectiveness of Single-Anastomosis Duodenal Switch Procedure 2-Year Result from a Single US Institution
|CONCLUSIONS: Loop DS seems to be effective in weight loss and is a feasible operation in the super-obese population. However, close monitoring of liver enzymes is warranted in addition to nutritional follow-up.
|Conversion of Laparoscopic Adjustable Gastric Banding to Gastric Bypass a Comparison to Primary Gastric Bypass
|CONCLUSION: Albeit longer operating time, revision of LAGB to LRYGB is a safe procedure, with similar complication rates when compared to primary LRYGB. Although revisional LRYGB does result in less weight loss than primary LRYGB, the procedure's safety makes it a very plausible option as a rescue o...
|Assessing risk factors, presentation, and management of portomesenteric vein thrombosis after sleeve gastrectomy a multicenter case-control study
|CONCLUSION: Incidence of PMVT is low after sleeve gastrectomy. A personal history of malignancy and type 2 diabetes increase the risk of PMVT. Increasing abdominal pain in a context of dehydration is common presenting symptoms with diagnosis confirmed by computed tomography. Anticoagulation is the s...
|Comparison of Banded Versus Non-banded Roux-en-Y Gastric Bypass a Series of 1150 Patients at a Single Institution
|CONCLUSIONS: Banded laparoscopic RYGB with a pericardial patch may not demonstrate a significant additional weight loss or prevent future weight regain. We were not able to demonstrate a clear advantage of banded RYGB over non-banded RYGB.
|Single-center experience in single-stage conversions of gastric banding to sleeve gastrectomy is it as safe as 2-stage conversions
|CONCLUSION: Single-stage laparoscopic conversion of LAGB to LSG is feasible and, in appropriately selected patients, does not seem to increase the risk of complications compared with 2-stage procedures.
|Techniques of Single-Stage Laparoscopic Conversion of Roux-en-Y Gastric Bypass to Single Anastomosis Bilio-pancreatic Diversion with Duodenal Switch
|CONCLUSION: Conversion of RYGB to single anastomosis duodenal switch can be a complicated operation, requiring a two-stage approach in most cases. With the adoption of the described technique, it can be easier to be achieved in a single-stage.
|Safety and effectiveness of anterior fundoplication sleeve gastrectomy in patients with severe reflux
|CONCLUSION: Anterior fundoplication sleeve gastrectomy may be a safe and effective alternative in obese patients with severe reflux who want to undergo sleeve gastrectomy.
|Robotic-Assisted Laparoscopic Biliopancreatic Diversion, Vertical Sleeve Gastrectomy with Traditional Roux-en-Y Duodenal Switch
|CONCLUSION: With the adoption of robots and the described technique, it can be easier to be achieved in less time.
|SAFETY AND EFFECTIVENESS OF SINGLE ANASTOMOSIS DUODENAL SWITCH PROCEDURE PRELIMINARY RESULT FROM A SINGLE INSTITUTION
|CONCLUSIONS: SADI-S is a feasible operation with a promising weight loss and diabetes resolution in the super-obese population.
|Septotomy and Balloon Dilation to Treat Chronic Leak After Sleeve Gastrectomy Technical Principles
|CONCLUSIONS: Septotomy and balloon dilation were initially performed on a difficult-to-treat chronic fistula after gastric bypass and named before as stricturotomy (Campos JM, Siqueira LT, Ferraz AA, et al., J Am Coll Surg 204(4):711, 2007). This procedure allows internal drainage of the fistula and...
|Robot-Assisted Versus Laparoscopic Sleeve Gastrectomy Learning Curve, Perioperative, and Short-Term Outcomes
|CONCLUSIONS: Our study showed similar 30-day readmission and reoperation rate between LSG and RA-LSG during the learning curve and after the proficiency has been achieved.
|Endoscopic treatment of food intolerance after a banded gastric bypass inducing band erosion for removal using a plastic stent
|CONCLUSIONS: Endoscopic removal of the ring using SEPS appeared to be safe and effective after a banded RYGB.
|Outcomes of Roux-en-Y gastric bypass in the super obese comparison of body mass index 50-60 kgm2 and60 kgm2 with the morbidly obese
|CONCLUSION: Readmission and reoperation rates were similar in the BMI 40-50, 50-60, and≥60 kg/m(2) groups. Super-obese and super-super-obese patients are not at greater risk for surgical complications compared with those with lower BMIs.
|Gastrojejunal Anastomosis Perforation after Gastric Bypass on a Patient with Underlying Pancreatic Cancer A Case Report and Review of the Literature
|Introduction. We describe a case of gastrojejunal anastomosis perforation after gastric bypass on a patient with underlying pancreatic cancer. Case Description. A 54-year-old female with past surgical history of gastric bypass for morbid obesity and recent diagnosis of unresectable pancreatic cancer...
|Training model for laparoscopic Heller and Dor fundoplication a tool for laparoscopic skills training and assessment-construct validity using the GOALS score
|CONCLUSIONS: The laparoscopic Heller-Dor training model has construct validity. The model may be used as a tool for training of the surgical resident.
|Robotic Roux-en-Y Gastric Bypass, is it Safer than Laparoscopic Bypass
|CONCLUSIONS: Robot-assisted Roux-en-Y gastric bypass may result in higher leak rate at the pouch level, when compared to that of laparoscopic procedures.
|Methylene Blue or Upper GI, Which is More Effective for Detecting Leaks in Gastric Bypass Patients
|CONCLUSIONS: UGI studies and methylene blue challenges had no significant difference in detecting a postoperative leak. Furthermore, these tests may have limited utility and may warrant adjuncts to aid in leak detection.
|Gastrobronchial Fistula in Sleeve Gastrectomy and Roux-en-Y Gastric Bypass--A Systematic Review
|Gastrobronchial fistula (GBF) is a rare surgical complication after bariatric surgery. We aimed to identify the clinical aspects of GBF and establish diagnostic and treatment strategies. A literature search was conducted in December 2013, in the PubMed electronic database. Eleven studies were select...
|Morbidity Rates and Weight Loss After Roux-en-Y Gastric Bypass, Sleeve Gastrectomy, and Adjustable Gastric Banding in Patients Older Than 60 Years old Which Procedure to Choose
|CONCLUSIONS: LSG showed the lowest readmission and reoperation rate, and RYGB patients had the highest mortality rate. Weight loss and comorbidity resolution were effectively achieved in RYGB and LSG patients.
|Duodenal stump leak following a duodenal switch A case report
|CONCLUSION: Duodenal stump leaks must be diagnosed as early as possible, and treated appropriately with operative intervention. Regardless of the operative technique the key to appropriate treatment is stabilize the patient, repair the duodenal stump, and adequate drainage.
|Indications and outcomes of reversal of Roux-en-Y gastric bypass
|CONCLUSIONS: Reversal of RYGB to normal anatomy is reasonable in patients with severe or refractory complications.
|Management of staple line leaks following sleeve gastrectomy
|CONCLUSION: Management of leaks after LSG can be challenging. Early diagnosis and treatment is important in the management of a leak. However, it can be treated safely via various management options depending on the time of diagnosis and size of the leak.
|Is preoperative manometry necessary for evaluating reflux symptoms in sleeve gastrectomy patients
|CONCLUSION: Manometric study may be necessary in LSG patients to accurately evaluate GERD and the LES pressure.
|Ultrasound evaluation of visceral and subcutaneous fat reduction in morbidly obese subjects undergoing laparoscopic gastric banding, sleeve gastrectomy, and Roux-en-Y gastric bypass a prospective comparison study
|CONCLUSION: LSG and LRYGB show better preferential and overall VF reduction than LAGB. US may serve as a simple tool of evaluating postoperative fat distribution.
|Safety and effectiveness of Roux-en-Y gastric bypass in patients between the ages of 17 and 19
|CONCLUSION: LRYGB in younger patients almost the age of 20 is both safe and effective when compared to matched adults in regard to weight loss, comorbid condition, and complications.
|Intussusception after Roux-en-Y gastric bypass
|CONCLUSION: While reduction alone of the intussusception is safe and effective, there is a risk of recurrence, and imbrication of the J-J anastomosis may be a more effective means of treatment.
|Laparoscopic choledochoduodenostomy as an alternate treatment for common bile duct stones after Roux-en-Y gastric bypass
|CONCLUSION: This small case series suggests that, in experienced hands, laparoscopic choledochoduodenostomy is an option for safe and effective treatment of choledocholithiasis after gastric bypass.
|Management and treatment outcomes of marginal ulcers after Roux-en-Y gastric bypass at a single high volume bariatric center
|CONCLUSION: Despite the use of routine PPI, the incidence of MU was not insignificant. A significant portion of patients required surgical treatment. Perforations can be effectively managed by oversewing of the ulcer.
|Treatment of weight regain following roux-en-Y gastric bypass revision of pouch, creation of new gastrojejunostomy and placement of proximal pericardial patch ring
|In the literature, weight regain or failure of weight loss has been reported in up to 35% of patients after Roux-en-Y gastric bypass (RYGB). Several revisional procedures have been suggested to reinitiate further weight loss in this group of patients, and placing a silastic ring around the pouch pro...
|Outcomes of laparoscopic sleeve gastrectomy in patients older than 60 years
|CONCLUSIONS: LSG is safe and very efficient in patients aged >60, despite higher rates of perioperative comorbidities.
|Causes of small bowel obstruction after Roux-en-Y gastric bypass a review of 2,395 cases at a single institution
|CONCLUSIONS: Our findings indicate a 3.9 % reoperation rate for abdominal pain and SBO, and more than 45 % of these patients had symptoms secondary to adhesions. Only 1.1 % of our laparoscopic RYGB patients developed internal herniation after closure of both internal hernia spaces.
|Femoral hernia sac laparoscopy a case report
|We present the case of a 64-year-old female with an incarcerated right femoral hernia, associated with a small bowel obstruction that was successfully treated with an open femoral hernia repair with plug. At the same time we performed a hernia sac laparoscopy to evaluate the viability of the previou...
|Comparison of cholecystectomy cases after Roux-en-Y gastric bypass, sleeve gastrectomy, and gastric banding
|CONCLUSIONS: Frequency of symptomatic gallstones after LRYGB and LSG was not significantly different and after LAGB was significantly lower. Slow and less amount of weight loss would have contributed to the low rate of symptomatic gallstone formation in the LAGB patients.
|Conversion of failed laparoscopic adjustable gastric banding sleeve gastrectomy or Roux-en-Y gastric bypass
|CONCLUSION: Converting LAGB to LSG and LRYGB both seem feasible and resulted in substantial further weight loss.
|Reinforcing the staple line with Surgicel Nu-knit in Roux-en-Y gastric bypass comparison with bovine pericardial strips
|CONCLUSIONS: The use of absorbable hemostat as buttress material may be effective in reducing acute postoperative bleeding in LRYGB at a significantly lower cost.
|Pericardial patch ring Roux-en-Y gastric bypass a preliminary report
|CONCLUSIONS: Longer follow-up is needed to prove the true efficacy of this procedure in reducing weight gain. Pericardial patch ring RYGB seems to be a safe alternative for banded RYGB of other materials.
|Routine gastrostomy tube placement in gastric bypass patients impact on length of stay and 30-day readmission rate
|CONCLUSIONS: Routine gastrostomy tube placement in the gastric remnant at the time of RYGB seems to have contributed to our short LOS and low 30-day readmission rate.
|Comparison of pediatric appendectomy outcomes between pediatric surgeons and general surgery residents
|CONCLUSIONS: The results of this study suggest that the presence of a PS does not affect the outcomes of appendectomies.
|Outcomes of bariatric surgery in patients gt;70 years old
|CONCLUSION: Bariatric surgery in carefully screened patients aged >70 years can be performed safely and can achieve modest improvement in co-morbidities.
|Laparoscopic sleeve gastrectomy a first step for rapid weight loss in morbidly obese patients requiring a second non-bariatric procedure
|CONCLUSIONS: In this small group, laparoscopic sleeve gastrectomy appears to be an effective and safe first surgical approach for rapid weight loss in high-risk patients that require a second non-bariatric procedure.
|Chyloperitoneum after laparoscopic Roux-en-Y gastric bypass LRYGB
|A true chylous effusion is defined as the presence of ascitic fluid with high fat (triglyceride) content, usually higher than 110 mg/dl. We report a case of chyloperitoneum following laparoscopic Roux-en-Y gastric bypass (LRYGB) in a 40-year-old patient who was admitted for surgery on May 31, 2007. ...
|Continuous positive airway pressure in immediate postoperative period after laparoscopic Roux-en-Y gastric bypass is it safe
|CONCLUSION: The use of CPAP after LRYGB did not result in increased the morbidity in our patient series.
|Diagnosis and treatment of megaesophagus after adjustable gastric banding for morbid obesity
|CONCLUSION: Megaesophagus is a possible late complication after LAGB. The preoperative manometry results cannot predict for its occurrence. The management of megaesophagus caused by LAGB requires, in most cases, band removal.