Erridge and you can acquaintances (2016) summarized new scientific programs out-of pure opening transluminal endoscopic surgery (NOTES) in the bariatric surgery

These detectives achieved a look at analysis, until away from techniques and you may effects of bariatric Cards steps. All in all, nine guides was basically within the finally investigation, with other 6 files detailing endolumenal strategies integrated to have investigations. Most of the Cards knowledge accompanied a crossbreed process. Crossbreed Cards sleeve gastrectomy (hNSG) was demonstrated in the 4 humans and dating for seniors you can 2 porcine degree. When you look at the individuals, six victims (23.step 1 %) were converted to old-fashioned laparoscopic tips, and you may 1 post-surgical side-effect (step three.8 %) are advertised. Indicate additional weight loss is actually 46.6 % (selection of 35.dos to 58.9). The brand new writers concluded that transvaginal-assisted sleeve gastrectomy looked possible and you may secure when did from the appropriately coached benefits. However, it reported that improvements need to be designed to defeat latest tech restrictions.

An enthusiastic UpToDate review to your “Natural orifice transluminal endoscopic operations (NOTES)” (Pasricha and you can Rivas, 2018) says you to “Pure opening transluminal endoscopic businesses (NOTES) was a growing job inside gastrointestinal businesses and you may interventional gastroenterology inside which the doctor accesses this new peritoneal hole through a hollow viscus and you will performs diagnostic and you can therapeutic measures … There clearly was even more that have to be been aware of it procedure, for instance the risk of peritoneal pollution. To date, the fresh new readily available human anatomy out-of medical sense does not show deleterious effects linked to contaminants and next infection. At the moment, Notes nevertheless should be thought about mostly experimental and must performed just inside a research setting”.

Chocolate Cane Problem (Roux Syndrome)

Candy cane disorder (CCS), and this is also known as Roux disorder otherwise Sweets cane Roux problem, are an unusual side-effect for the customers once Roux-en-Y gastric bypass surgery. It occurs when there is a way too high period of roux limb proximal in order to gastrojejunostomy, carrying out the possibility to possess restaurants dirt in order to lodge and remain when you look at the the blind redundant limb.

The got pre-surgical functions-to 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.