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ABSTRACT
Background: The use of robotic-assisted bariatric surgery has recently gained an increased amount of positive reception. In this paper we share our experiences with robotic-assisted bariatric surgery in hopes of increasing the surgical team members’ (such as surgical residents, circulators, scrub technicians and surgical assistants) abilit...
Context in source publication
Context 1
... standard procedure of both robotic RYGB and VSG have been described in many studies (8)(9)(10)(11). Figure 5 shows anatomy pictures of gastric bypass (left) and sleeve gastrectomy (right) after they were done. After the procedures, the intralumen anastomosis is insufflated using a gastroscope (under extralumen irrigation) to verify the absence of leakage. ...
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Objetivo:
Comparar los resultados obtenidos en calidad de vida, pérdida ponderal y resolución de comorbilidades al año, en pacientes con obesidad mórbida intervenidos de Gastrectomía vertical laparoscópica (GVL) o bypass gástrico en Y de Roux laparoscópico (BGYRL) en nuestro centro.
Materiales y Método:
Estudio observacional de una base de datos p...
Resumen: Obesidad es una patología emergente, crónica multifactorial asociada al incremento de riesgo de diabetes y enfermedad cardiovascular. El tratamiento quirúrgico es un pilar fundamental y mas hoy en día con el empleo de abordajes mínimamente invasivos. Presentamos nuestra experiencia en el tratamiento quirúrgico de la obesidad mórbida en el...
Background
Following bariatric surgery, accurate charting of weight loss and regain is crucial. Various preoperative factors affect postoperative weight loss, including age, sex, ethnicity, and surgical type. These are not considered by current weight loss metrics, limiting comparison of weight loss outcomes between patients or centers and across t...
Introduction:
Use of sleeve gastrectomy (SG) for weight loss has grown exponentially; however, clear indications for SG versus Roux-en-Y gastric bypass (RNYGB) are lacking. Certain populations may be more likely to undergo SG due to its simpler technique and without clear clinical indications. We aim to examine underlying predictors of patients un...
Bariatric surgery is a medical specialty dedicated to the treatment of obesity and its comorbidities through surgical procedures. We present a detailed collection on the history and evolution of laparoscopic sleeve gastrectomy over the course of 20 years. The gastric sleeve induces weight loss by several mechanisms. It significantly reduces gastric...
Citations
... The small intestine is separated at the jej biliopancreatic limb (≈40 cm, composed of the duodenum and proximal jej continuity with stomach) and a Roux limb (75-150 cm, beginning where jeju top of the Roux limb is surgically attached to the stomach pouch, and the bo biliopancreatic limb [7]. The illustration was obtained from [8]. ...
... The top of the Roux limb is surgically attached to the stomach pouch, and the bottom is attached to the biliopancreatic limb [7]. The illustration was obtained from [8]. ...
In this investigation, PBPK modeling using the Simcyp® Simulator was performed to evaluate whether Roux-en-Y gastric bypass (RYGB) surgery impacts the oral absorption and bioavailability of azithromycin. An RYGB surgery patient population was adapted from the published literature and verified using the same probe medications, atorvastatin and midazolam. Next, a PBPK model of azithromycin was constructed to simulate changes in systemic drug exposure after the administration of different oral formulations (tablet, suspension) to patients pre- and post-RYGB surgery using the developed and verified population model. Clinically observed changes in azithromycin systemic exposure post-surgery following oral administration (single-dose tablet formulation) were captured using PBPK modeling based on the comparison of model-predicted exposure metrics (Cmax, AUC) to published clinical data. Model simulations predicted a 30% reduction in steady-state AUC after surgery for three- and five-day multiple dose regimens of an azithromycin tablet formulation. The relative bioavailability of a suspension formulation was 1.5-fold higher than the tablet formulation after multiple dosing. The changes in systemic exposure observed after surgery were used to evaluate the clinical efficacy of azithromycin against two of the most common pathogens causing community acquired pneumonia based on the corresponding AUC24/MIC pharmacodynamic endpoint. The results suggest lower bioavailability of the tablet formulation post-surgery may impact clinical efficacy. Overall, the research demonstrates the potential of a PBPK modeling approach as a framework to optimize oral drug therapy in patients post-RYGB surgery.
... 16 Laparoscopy sleeve gastrectomy (LSG) is the most commonly performed bariatric surgery in the United States and consists of the creation of a tubular stomach by removing the majority of the greater curvature of the stomach, including the fundus 16 (Fig. 2, right). 17 The remaining stomach has decreased capacity with resistance to expansion, making LSG a restrictive procedure. In addition, postoperatively LSG has been shown to uniquely decrease fasting and postprandial ghrelin levels, leading to appetite suppression. ...
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