Document Detail


Laparoscopic sleeve gastrectomy--volume and pressure assessment.
MedLine Citation:
PMID:  18535864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Aiming to clarify the mechanism of weight loss after the restrictive bariatric procedure of sleeve gastrectomy (LSG), the volumes and pressures of the stomach, of the removed part, and of the remaining sleeve were measured in 20 morbidly obese patients. METHODS: The technique used consisted of occlusion of the pylorus with a laparoscopic clamp and of the gastroesophageal junction with a special orogastric tube connected to a manometer. Instillation of methylene-blue-colored saline via the tube was continued until the intraluminal pressure increased sharply, or the inflated stomach reached 2,000 cc. After recording of measurements, LSG was performed. RESULTS: Mean volume of the entire stomach was 1,553 cc (600-2,000 cc) and that of the sleeve 129 cc (90-220 cc), i.e., 10% (4-17%) and that of the removed stomach was 795 cc (400-1,500 cc). The mean basal intragastric pressure of the whole stomach after insufflations of the abdominal cavity with CO(2) to 15 mmHg was 19 mmHg (11-26 mmHg); after occlusion and filling with saline it was 34 mmHg (21-45 mmHg). In the sleeved stomach, mean basal pressure was similar 18 mmHg (6-28 mmHg); when filled with saline, pressure rose to 43 mmHg (32-58 mmHg). The removed stomach had a mean pressure of 26 mmHg (12-47 mmHg). There were no postoperative complications and no mortality. CONCLUSIONS: The notably higher pressure in the sleeve, reflecting its markedly lesser distensibility compared to that of the whole stomach and of the removed fundus, indicates that this may be an important element in the mechanism of weight loss.
Authors:
Ronit T Yehoshua; Leonid A Eidelman; Michael Stein; Suzana Fichman; Amir Mazor; Jacopo Chen; Hanna Bernstine; Pierre Singer; Ram Dickman; Nahum Beglaibter; Scott A Shikora; Raul J Rosenthal; Moshe Rubin
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2008-06-06
Journal Detail:
Title:  Obesity surgery     Volume:  18     ISSN:  0960-8923     ISO Abbreviation:  Obes Surg     Publication Date:  2008 Sep 
Date Detail:
Created Date:  2008-08-12     Completed Date:  2009-01-27     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  9106714     Medline TA:  Obes Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1083-8     Citation Subset:  IM    
Affiliation:
Felsenstein Medical Research Center, Beilinson Campus, Petach-Tikva, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Compliance
Female
Gastrectomy*
Gastric Stump / pathology*,  physiopathology
Humans
Laparoscopy*
Male
Middle Aged
Obesity, Morbid / pathology*,  physiopathology,  surgery*
Organ Size
Pressure
Prospective Studies
Weight Loss
Young Adult
Comments/Corrections
Erratum In:
Obes Surg. 2009 Jan;19(1):134
Note: Beglaibter, Nahum [added]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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