Erridge and you can associates (2016) described new medical applications from natural orifice transluminal endoscopic procedures (NOTES) in bariatric functions

Such detectives carried out a review of analysis, until out-of procedure and you will outcomes of bariatric Notes measures. All in all, 9 publications were within the finally data, with several other six papers detailing endolumenal procedures incorporated having research. The Notes education used a crossbreed procedure. Hybrid Notes case gastrectomy (hNSG) try revealed in the cuatro humans and you may 2 porcine training. From inside the individuals, 6 victims (23.step 1 %) have been changed into traditional laparoscopic actions, and you may step 1 blog post-operative complication (step 3.8 %) was reported. Indicate additional weight losses is actually 46.6 % (directory of thirty five.2 to 58.9). The fresh writers determined that transvaginal-helped arm gastrectomy looked feasible and secure whenever performed of the appropriately instructed professionals. not, it stated that improvements need to be made to overcome newest tech limitations.

A keen UpToDate comment into the «Pure beginning transluminal endoscopic surgery (NOTES)» (Pasricha and you can Rivas, 2018) claims that «Pure orifice transluminal endoscopic procedures (NOTES) was an emerging profession inside intestinal surgery and you may interventional gastroenterology inside the that doctor accesses the newest peritoneal hole through a hollow viscus and works diagnostic and healing strategies … There was so much more that must definitely be heard about which processes, for instance the danger of peritoneal contaminants. Yet, the latest available muscles out of systematic experience cannot demonstrate deleterious outcomes connected with toxic contamination and then issues. At present, Cards nonetheless should be thought about mostly experimental and really should be done simply in the a research means».

Sweets Cane Syndrome (Roux Syndrome)

Sweets cane syndrome (CCS), which is also labeled as Roux problem or Candy cane Roux syndrome, is actually an uncommon effect inside the patients immediately following Roux-en-Y gastric sidestep procedures. It occurs when there is a too much length of roux limb proximal so you can gastrojejunostomy, doing the possibility having dinner dust to help you lodge and remain in the this new blind redundant limb.

All got pre-operative work-as much as identify 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.