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Michel VIX

MD
Hôpitaux Universitaires de Strasbourg
Strasbourg, France
144 videos
294.7K views
46 comments
6.2K likes
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Fully robotic Roux-en-Y gastric bypass
Roux-en-Y gastric bypass is becoming increasingly popular. The use of the surgical robot is developing rapidly, and this is especially true for digestive surgery. The aim of this video is to show that Roux-en-Y gastric bypass can be performed using a totally robotic approach. When using the robot, one follows the same steps as for a conventional intervention. The 3D vision and the degrees of freedom of the instruments facilitate the dissection, especially around the cardia, and for suturing procedures. The surgeon takes advantage of the console's user friendly set-up which does not put his/her shoulders or back in a vulnerable position, as they sometimes are when using a laparoscopic approach.
Surgical intervention
1 year ago
1897 views
8 likes
0 comments
12:00
Fully robotic Roux-en-Y gastric bypass
Roux-en-Y gastric bypass is becoming increasingly popular. The use of the surgical robot is developing rapidly, and this is especially true for digestive surgery. The aim of this video is to show that Roux-en-Y gastric bypass can be performed using a totally robotic approach. When using the robot, one follows the same steps as for a conventional intervention. The 3D vision and the degrees of freedom of the instruments facilitate the dissection, especially around the cardia, and for suturing procedures. The surgeon takes advantage of the console's user friendly set-up which does not put his/her shoulders or back in a vulnerable position, as they sometimes are when using a laparoscopic approach.
Fully robotically assisted transabdominal left adrenalectomy for hypercortisolism due to two left adrenal adenomas
This video demonstrates the case of a female patient who had been followed up by endocrinologists for 6 years. The size of the left adrenal gland had increased and two nodules of 2.5cm were found. Serum chemistries showed a progressive increase in cortisol secretion with a pathological dexamethasone suppression test (DST). Mineralocorticoids and catecholamines were normal. Noriodocholesterol scintigraphy showed an exclusive fixation of the left adrenal gland. Surgery was indicated due to the hypersecretion of the left adrenal gland.
We now have a surgical robot (da Vinci Xi™ robotic surgical system, Intuitive Surgical) and we use it for most of the adrenalectomies we perform. It provides great stability of the operative field. The precise dissection is facilitated by the dexterity of the articulated instruments.
Surgical intervention
1 year ago
1400 views
10 likes
0 comments
13:06
Fully robotically assisted transabdominal left adrenalectomy for hypercortisolism due to two left adrenal adenomas
This video demonstrates the case of a female patient who had been followed up by endocrinologists for 6 years. The size of the left adrenal gland had increased and two nodules of 2.5cm were found. Serum chemistries showed a progressive increase in cortisol secretion with a pathological dexamethasone suppression test (DST). Mineralocorticoids and catecholamines were normal. Noriodocholesterol scintigraphy showed an exclusive fixation of the left adrenal gland. Surgery was indicated due to the hypersecretion of the left adrenal gland.
We now have a surgical robot (da Vinci Xi™ robotic surgical system, Intuitive Surgical) and we use it for most of the adrenalectomies we perform. It provides great stability of the operative field. The precise dissection is facilitated by the dexterity of the articulated instruments.
Laparoscopic cholecystectomy in a patient with nonalcoholic steatohepatitis (NASH) and idiopathic thrombocytopenic purpura
Morbid obesity surgery, which induces a rapid weight loss, is a predisposing factor for the onset of gallstones. There are treatments which help to reduce this risk. However, the observance is poor and lithogenicity brings about risks of complications such as cholecystitis, stone migration, and acute pancreatitis.
This video demonstrates the case of a patient who underwent a sleeve gastrectomy with a substantial weight loss. Stone migration was found along with a less serious pancreatic response. During a blood test analysis, thrombocytopenia was found and investigated by hematologists. Besides a low platelet count, a qualitative anomaly was observed increasing the risk of bleeding. Despite of this, cholecystectomy was necessary to prevent any new stone migration.
The operator was skilled and used a conventional laparoscopic approach. The patient’s liver is the site of a nonalcoholic steatohepatitis (NASH), making the procedure even more complex. Four ports were placed to allow for an adequate gallbladder retraction and for a minute dissection. Calot’s triangle was classically approached first as soon as the adhesions between the omentum and the gallbladder were taken down. Due to a thickened and inflammatory cystic duct, the entire gallbladder was dissected before ligating the cystic duct with two ligatures, one of them being reinforced by means of a surgical loop.
Surgical intervention
1 year ago
1137 views
4 likes
0 comments
13:25
Laparoscopic cholecystectomy in a patient with nonalcoholic steatohepatitis (NASH) and idiopathic thrombocytopenic purpura
Morbid obesity surgery, which induces a rapid weight loss, is a predisposing factor for the onset of gallstones. There are treatments which help to reduce this risk. However, the observance is poor and lithogenicity brings about risks of complications such as cholecystitis, stone migration, and acute pancreatitis.
This video demonstrates the case of a patient who underwent a sleeve gastrectomy with a substantial weight loss. Stone migration was found along with a less serious pancreatic response. During a blood test analysis, thrombocytopenia was found and investigated by hematologists. Besides a low platelet count, a qualitative anomaly was observed increasing the risk of bleeding. Despite of this, cholecystectomy was necessary to prevent any new stone migration.
The operator was skilled and used a conventional laparoscopic approach. The patient’s liver is the site of a nonalcoholic steatohepatitis (NASH), making the procedure even more complex. Four ports were placed to allow for an adequate gallbladder retraction and for a minute dissection. Calot’s triangle was classically approached first as soon as the adhesions between the omentum and the gallbladder were taken down. Due to a thickened and inflammatory cystic duct, the entire gallbladder was dissected before ligating the cystic duct with two ligatures, one of them being reinforced by means of a surgical loop.
Fully robotically assisted transabdominal right adrenalectomy for a right adrenal incidentaloma
This video presents the case of a female patient in whom a right adrenal incidentaloma was found. It was 40mm in size and was found incidentally during a pancreatitis treatment.
Endocrinologists controlled the absence of abnormal secretion. The size of the lesion increased slightly over a period of 6 months and allowed to establish an indication for surgery. Our team performs adrenalectomies using a transabdominal laparoscopic approach with the patient in a lateral decubitus position. In order to facilitate the intervention, we asked the Visible Patient company to use the CT-scan images to make a 3D model. This reconstruction allowed to better indentify the relationships of the gland, to improve resection, and confirm the operative strategy. During the intervention, the surgeon can use it to better understand the anatomy hidden by peri-adrenal adipose tissue and operate accordingly. We now have a surgical robot (da Vinci Xi™ robotic surgical system, Intuitive Surgical) and we use it for most of the adrenalectomies we perform. It provides great stability of the operative field. The precise dissection is facilitated by the dexterity of the articulated instruments.
Surgical intervention
1 year ago
1717 views
2 likes
0 comments
11:41
Fully robotically assisted transabdominal right adrenalectomy for a right adrenal incidentaloma
This video presents the case of a female patient in whom a right adrenal incidentaloma was found. It was 40mm in size and was found incidentally during a pancreatitis treatment.
Endocrinologists controlled the absence of abnormal secretion. The size of the lesion increased slightly over a period of 6 months and allowed to establish an indication for surgery. Our team performs adrenalectomies using a transabdominal laparoscopic approach with the patient in a lateral decubitus position. In order to facilitate the intervention, we asked the Visible Patient company to use the CT-scan images to make a 3D model. This reconstruction allowed to better indentify the relationships of the gland, to improve resection, and confirm the operative strategy. During the intervention, the surgeon can use it to better understand the anatomy hidden by peri-adrenal adipose tissue and operate accordingly. We now have a surgical robot (da Vinci Xi™ robotic surgical system, Intuitive Surgical) and we use it for most of the adrenalectomies we perform. It provides great stability of the operative field. The precise dissection is facilitated by the dexterity of the articulated instruments.
Bariatric and metabolic surgery
In this authoritative lecture, Dr. Michel Vix highlighted the indications related to metabolic and morbid obesity surgery. He presented key anatomical landmarks and operating room (OR) set-up depending on every patient. He briefly described the main principles of port placement and pneumoperitoneum, and demonstrated maneuvers, indications, and main key steps of morbid obesity procedures including LAGB, SBPD-DS, Scopinaro, RYGB, Mini Gastric Bypass, and Sleeve Gastrectomy, along with their technical aspects, mortality, morbidity, effectiveness, and results using different studies and meta-analyses. He also demonstrated the main principles and key steps of new trends and approaches in bariatric and metabolic surgery with complications and technical therapeutic aspects.
Lecture
2 years ago
1637 views
273 likes
0 comments
04:52
Bariatric and metabolic surgery
In this authoritative lecture, Dr. Michel Vix highlighted the indications related to metabolic and morbid obesity surgery. He presented key anatomical landmarks and operating room (OR) set-up depending on every patient. He briefly described the main principles of port placement and pneumoperitoneum, and demonstrated maneuvers, indications, and main key steps of morbid obesity procedures including LAGB, SBPD-DS, Scopinaro, RYGB, Mini Gastric Bypass, and Sleeve Gastrectomy, along with their technical aspects, mortality, morbidity, effectiveness, and results using different studies and meta-analyses. He also demonstrated the main principles and key steps of new trends and approaches in bariatric and metabolic surgery with complications and technical therapeutic aspects.
Minimally invasive right superior parathyroidectomy (MIVAP) for symptomatic primary hyperparathyroidism
This video presents the case of a 62 year-old patient with primary hyperparathyroidism characterized by a PTH which is inconsistent with calcium levels. The diagnosis is confirmed by biological findings before searching for the adenoma inducing this hypersecretion. With the use of current precision imaging techniques, in most cases, the adenoma can be identified and managed surgically. In our team, we perform a 99m Tc-MIBI scintigraphy and a CT-scan allowing for a 3D reconstruction according to the IRCAD protocol. This 3D reconstruction shows the relationships between the adenoma, the inferior thyroid artery, the thyroid gland, and the esophagus, making it possible to perform a video-assisted approach using a scar inferior to 2cm.
Surgical intervention
3 years ago
1332 views
121 likes
1 comment
08:28
Minimally invasive right superior parathyroidectomy (MIVAP) for symptomatic primary hyperparathyroidism
This video presents the case of a 62 year-old patient with primary hyperparathyroidism characterized by a PTH which is inconsistent with calcium levels. The diagnosis is confirmed by biological findings before searching for the adenoma inducing this hypersecretion. With the use of current precision imaging techniques, in most cases, the adenoma can be identified and managed surgically. In our team, we perform a 99m Tc-MIBI scintigraphy and a CT-scan allowing for a 3D reconstruction according to the IRCAD protocol. This 3D reconstruction shows the relationships between the adenoma, the inferior thyroid artery, the thyroid gland, and the esophagus, making it possible to perform a video-assisted approach using a scar inferior to 2cm.
PerOral Endoscopic Thyroidectomy (POET), a novel pioneering technique
Thyroid surgery has evolved towards minimally invasive approaches to reduce or prevent cervical scars, which are potential seats for keloidal scarring. Several approaches have been put forward: video-assisted surgery via a reduced cervical scar, transaxillary access with or without robotic assistance, transoral retromandibular approach, retroauricular approach in keeping with a lifting procedure.
In this video, we present the case of an original transoral vestibular approach. This access is exclusively subcutaneous. No cervical scar is necessary. This technique allows for a unilateral or bilateral approach in excellent visualization conditions. Dissection is performed from cranially to caudally with the rapid identification of the inferior laryngeal nerve.
Surgical intervention
3 years ago
5094 views
329 likes
2 comments
25:34
PerOral Endoscopic Thyroidectomy (POET), a novel pioneering technique
Thyroid surgery has evolved towards minimally invasive approaches to reduce or prevent cervical scars, which are potential seats for keloidal scarring. Several approaches have been put forward: video-assisted surgery via a reduced cervical scar, transaxillary access with or without robotic assistance, transoral retromandibular approach, retroauricular approach in keeping with a lifting procedure.
In this video, we present the case of an original transoral vestibular approach. This access is exclusively subcutaneous. No cervical scar is necessary. This technique allows for a unilateral or bilateral approach in excellent visualization conditions. Dissection is performed from cranially to caudally with the rapid identification of the inferior laryngeal nerve.
Video-assisted exploration of the four parathyroid lobes for primary hyperparathyroidism
Background:
The presence of a single parathyroid adenoma accurately located using preoperative imaging is the best indication for minimally invasive surgery when dealing with primary hyperparathyroidism. It is certainly possible to search for several glands that may be suspicious of adenoma, but an extensive experience in video-assisted cervical surgery is required to find the anatomical structures allowing to explore the four parathyroid locations.
Patient and methods:
A 75-year-old obese woman is diagnosed with hypercalcemia, hypophosphoremia, and a high level of PTH during a work-up for joint pain.

Preoperative imaging includes a 3D-reconstructed cervico-mediastinal CT-scan —a computer program developed at the IRCAD-Strasbourg, named VrAnat™, Vr planning™, is used for that purpose. This 3D virtual reconstruction demonstrates three suspicious images respectively located at the right superior parathyroid territory, at the right latero-esophageal area, and at the left inferior parathyroid territory. A video-assisted cervical exploration, guided by this reconstruction, is decided upon. The objective is to find the three suspicious images and to explore the four parathyroid glands.

A 3cm median incision is carried out 2cm above the sternal notch. The right thyrotracheal groove is reached through a dissection performed laterally to the strap muscles and medially to the omohyoid muscle. A complete dissection of the lateral aspect of the thyroid lobe is obtained using blunt dissection and small instruments under endoscopic vision, which is provided by a 30-degree, 5mm scope (Storz, Tüttlingen, Germany). The recurrent laryngeal nerve is identified.

Dissection is now carried on above the inferior thyroid artery. It allows to rapidly identify a superior parathyroid adenoma, which will be resected. It exactly matches with one of the suspicious images.

Dissection is pursued anterior to the intersection between the artery and the nerve so as to find the right inferior parathyroid, which is healthy, underneath the capsule. The latero-esophageal image is now searched for. It is nothing but an anthracosic lymph node.

The left side is approached by dissecting the left jugulocarotid gutter. The left recurrent nerve is identified. The left inferior parathyroid is identified and looks healthy. The suspected image is nothing else but a nodule of the apex of the thyrothymic ligament. The left superior parathyroid, which is healthy, can be finally identified in a strictly orthotopic position, although partially hidden behind a Zuckerkandl’s nodule.

Conclusion:
This cervical exploration has led to the dissection and visualization of the four parathyroid lobes in compliance with classical parathyroid surgery principles.
References:
Berti P, Materazzi G, Picone A, Miccoli P. Limits and drawbacks of video-assisted parathyroidectomy. Br J Surg 2003;90:743-7.

Miccoli P, Materazzi G, Baggiani A, Miccoli M. Mini-invasive video-assisted surgery of the thyroid and parathyroid glands: a 2011 update. J Endocrinol Invest 2011;34:473-80.
Surgical intervention
3 years ago
707 views
71 likes
0 comments
09:39
Video-assisted exploration of the four parathyroid lobes for primary hyperparathyroidism
Background:
The presence of a single parathyroid adenoma accurately located using preoperative imaging is the best indication for minimally invasive surgery when dealing with primary hyperparathyroidism. It is certainly possible to search for several glands that may be suspicious of adenoma, but an extensive experience in video-assisted cervical surgery is required to find the anatomical structures allowing to explore the four parathyroid locations.
Patient and methods:
A 75-year-old obese woman is diagnosed with hypercalcemia, hypophosphoremia, and a high level of PTH during a work-up for joint pain.

Preoperative imaging includes a 3D-reconstructed cervico-mediastinal CT-scan —a computer program developed at the IRCAD-Strasbourg, named VrAnat™, Vr planning™, is used for that purpose. This 3D virtual reconstruction demonstrates three suspicious images respectively located at the right superior parathyroid territory, at the right latero-esophageal area, and at the left inferior parathyroid territory. A video-assisted cervical exploration, guided by this reconstruction, is decided upon. The objective is to find the three suspicious images and to explore the four parathyroid glands.

A 3cm median incision is carried out 2cm above the sternal notch. The right thyrotracheal groove is reached through a dissection performed laterally to the strap muscles and medially to the omohyoid muscle. A complete dissection of the lateral aspect of the thyroid lobe is obtained using blunt dissection and small instruments under endoscopic vision, which is provided by a 30-degree, 5mm scope (Storz, Tüttlingen, Germany). The recurrent laryngeal nerve is identified.

Dissection is now carried on above the inferior thyroid artery. It allows to rapidly identify a superior parathyroid adenoma, which will be resected. It exactly matches with one of the suspicious images.

Dissection is pursued anterior to the intersection between the artery and the nerve so as to find the right inferior parathyroid, which is healthy, underneath the capsule. The latero-esophageal image is now searched for. It is nothing but an anthracosic lymph node.

The left side is approached by dissecting the left jugulocarotid gutter. The left recurrent nerve is identified. The left inferior parathyroid is identified and looks healthy. The suspected image is nothing else but a nodule of the apex of the thyrothymic ligament. The left superior parathyroid, which is healthy, can be finally identified in a strictly orthotopic position, although partially hidden behind a Zuckerkandl’s nodule.

Conclusion:
This cervical exploration has led to the dissection and visualization of the four parathyroid lobes in compliance with classical parathyroid surgery principles.
References:
Berti P, Materazzi G, Picone A, Miccoli P. Limits and drawbacks of video-assisted parathyroidectomy. Br J Surg 2003;90:743-7.

Miccoli P, Materazzi G, Baggiani A, Miccoli M. Mini-invasive video-assisted surgery of the thyroid and parathyroid glands: a 2011 update. J Endocrinol Invest 2011;34:473-80.
The VERSA LIFTER BAND™: a new option for liver retraction in laparoscopic Roux-en-Y gastric bypass for morbid obesity
During laparoscopic bariatric procedures in morbidly obese patients, the surgeon's operative view is often obscured by the hypertrophic adipose left lobe of the liver.
To provide adequate operative views and working space, an appropriate retraction of the left liver lobe is required.
The use of a conventional liver retractor mandates an additional subxiphoid wound, resulting in patient discomfort for pain and scar formation, with the additional risk of iatrogenic liver injury during retraction maneuvers.
To overcome these limitations, we present the use of a simple, rapid, and safe technique for liver retraction using the VERSA LIFTER™ Band disposable liver suspension system or retractor.
Surgical intervention
4 years ago
1769 views
38 likes
0 comments
03:48
The VERSA LIFTER BAND™: a new option for liver retraction in laparoscopic Roux-en-Y gastric bypass for morbid obesity
During laparoscopic bariatric procedures in morbidly obese patients, the surgeon's operative view is often obscured by the hypertrophic adipose left lobe of the liver.
To provide adequate operative views and working space, an appropriate retraction of the left liver lobe is required.
The use of a conventional liver retractor mandates an additional subxiphoid wound, resulting in patient discomfort for pain and scar formation, with the additional risk of iatrogenic liver injury during retraction maneuvers.
To overcome these limitations, we present the use of a simple, rapid, and safe technique for liver retraction using the VERSA LIFTER™ Band disposable liver suspension system or retractor.
Laparoscopic Roux-en-Y gastric bypass: live demonstration and technical details
Roux-en-Y gastric bypass (RYGB) has become a common procedure for the management of morbid obesity. However, learning to perform such a procedure may be difficult as it is made up of very technical operative steps in complex cases of overweight patients with a great amount of adipose tissue. In order to prevent complications, an operative strategy should be adopted, allowing for an easy and rapid acquisition of the technique. Each step is perfectly mastered and outlined.
This video demonstrates a laparoscopic Roux-en-Y gastric bypass performed live, showing all the preoperative and operative patient settings. The surgical technique is thoroughly explained.
Surgical intervention
4 years ago
7722 views
205 likes
1 comment
28:09
Laparoscopic Roux-en-Y gastric bypass: live demonstration and technical details
Roux-en-Y gastric bypass (RYGB) has become a common procedure for the management of morbid obesity. However, learning to perform such a procedure may be difficult as it is made up of very technical operative steps in complex cases of overweight patients with a great amount of adipose tissue. In order to prevent complications, an operative strategy should be adopted, allowing for an easy and rapid acquisition of the technique. Each step is perfectly mastered and outlined.
This video demonstrates a laparoscopic Roux-en-Y gastric bypass performed live, showing all the preoperative and operative patient settings. The surgical technique is thoroughly explained.
Laparoscopic Roux-en-Y gastric bypass after gastric band removal
This video demonstrates the case of a 50-year-old woman with morbid obesity (BMI of 39). She had a gastric banding placed 7 years before, which became ineffective 3 years after the primary surgery, resulting in band removal 2 years ago.
A secondary bariatric surgery was scheduled, with the decision to perform a laparoscopic Roux-en-Y gastric bypass. This video shows the surgical technique, with special emphasis on dissection of the cardia and lesser curvature, where the anatomy is altered as a result of the previous band. An interesting technical point occurs during the creation of the jejunojejunostomy, where a perforation of the biliary loop is accidentally made during the EndoGIATM linear stapler introduction.
Surgical intervention
4 years ago
2283 views
61 likes
0 comments
32:11
Laparoscopic Roux-en-Y gastric bypass after gastric band removal
This video demonstrates the case of a 50-year-old woman with morbid obesity (BMI of 39). She had a gastric banding placed 7 years before, which became ineffective 3 years after the primary surgery, resulting in band removal 2 years ago.
A secondary bariatric surgery was scheduled, with the decision to perform a laparoscopic Roux-en-Y gastric bypass. This video shows the surgical technique, with special emphasis on dissection of the cardia and lesser curvature, where the anatomy is altered as a result of the previous band. An interesting technical point occurs during the creation of the jejunojejunostomy, where a perforation of the biliary loop is accidentally made during the EndoGIATM linear stapler introduction.
Robot-assisted Roux-en-Y gastric bypass after band removal
Patients ask for a new weight loss surgical procedure after gastric band removal due to a lack of efficiency or to complications. Although gastric banding is a reversible procedure, perigastric adhesions located mostly in the upper part of the stomach can make new approaches to this area difficult.
We report the case of a woman who benefited from a gastric banding in 2006. This gastric band was removed in 2010. The patient developed a left subphrenic abscess, which was drained under CT-scan control postoperatively.
Two years after this procedure, the patient wishes to benefit from a new weight loss surgical procedure as she gained 10Kg since her gastric band removal. She has a BMI of 40 and presents with respiratory and rheumatological co-morbidities.
The preoperative work-up was uneventful, and this is particularly true for the esogastroduodenal contrast exam and the gastroscopy.
During the procedure, multiple omental parietal adhesions were found, as well as tight adhesions between the liver, the stomach, and the left crus.
Dissecting the stomach using a conventional approach was made difficult by the presence of these adhesions, and we had to perform an upper pole gastrectomy of the greater curvature in order to clearly identify the gastroesophageal junction’s anatomy. A complete dissection of the left subcardial area is necessary in order to prevent the formation of an excessively large gastric pouch, which could lead to a regain in weight.
This video covers the whole procedure in detail and highlights dissection challenges, which can occur in patients who had their gastric band removed.
The postoperative outcome was uneventful in this woman, with a significant weight loss at one year.
Surgical intervention
4 years ago
1420 views
46 likes
0 comments
25:55
Robot-assisted Roux-en-Y gastric bypass after band removal
Patients ask for a new weight loss surgical procedure after gastric band removal due to a lack of efficiency or to complications. Although gastric banding is a reversible procedure, perigastric adhesions located mostly in the upper part of the stomach can make new approaches to this area difficult.
We report the case of a woman who benefited from a gastric banding in 2006. This gastric band was removed in 2010. The patient developed a left subphrenic abscess, which was drained under CT-scan control postoperatively.
Two years after this procedure, the patient wishes to benefit from a new weight loss surgical procedure as she gained 10Kg since her gastric band removal. She has a BMI of 40 and presents with respiratory and rheumatological co-morbidities.
The preoperative work-up was uneventful, and this is particularly true for the esogastroduodenal contrast exam and the gastroscopy.
During the procedure, multiple omental parietal adhesions were found, as well as tight adhesions between the liver, the stomach, and the left crus.
Dissecting the stomach using a conventional approach was made difficult by the presence of these adhesions, and we had to perform an upper pole gastrectomy of the greater curvature in order to clearly identify the gastroesophageal junction’s anatomy. A complete dissection of the left subcardial area is necessary in order to prevent the formation of an excessively large gastric pouch, which could lead to a regain in weight.
This video covers the whole procedure in detail and highlights dissection challenges, which can occur in patients who had their gastric band removed.
The postoperative outcome was uneventful in this woman, with a significant weight loss at one year.
Robot-assisted gastric band removal
Adjustable gastric banding (AGB) is one of the surgical treatment modalities for morbid obesity. Over the years, popularity for this treatment increased. It has been by far the most performed bariatric procedure for years in Europe and in the United States. Many gastric band removals are linked to complications and weight loss failure, indicating a new bariatric procedure for some of the patients. Complications after AGB are not uncommon and consist mainly of gastroesophageal reflux disease, pouch dilatation, slippage of the band, and intragastric migration. The failure of the gastric band is multifactorial. Gastric band removal does not preclude a new bariatric procedure (the most common procedure performed in our department is Roux en-Y gastric bypass), which is feasible in the same operative time but the 2-step approach is suitable. The new bariatric procedure offers adequate surgical outcomes and satisfactory results in terms of weight loss.
Surgical intervention
4 years ago
1153 views
37 likes
0 comments
08:14
Robot-assisted gastric band removal
Adjustable gastric banding (AGB) is one of the surgical treatment modalities for morbid obesity. Over the years, popularity for this treatment increased. It has been by far the most performed bariatric procedure for years in Europe and in the United States. Many gastric band removals are linked to complications and weight loss failure, indicating a new bariatric procedure for some of the patients. Complications after AGB are not uncommon and consist mainly of gastroesophageal reflux disease, pouch dilatation, slippage of the band, and intragastric migration. The failure of the gastric band is multifactorial. Gastric band removal does not preclude a new bariatric procedure (the most common procedure performed in our department is Roux en-Y gastric bypass), which is feasible in the same operative time but the 2-step approach is suitable. The new bariatric procedure offers adequate surgical outcomes and satisfactory results in terms of weight loss.