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Petrucciani N, Carrano FM, Barone SC, Goglia M, Iadicicco E, Distefano G, Mucaj L, Stefanelli S, D'Angelo F, Aurello P, Silecchia G. Primary, revisional, and endoscopic bariatric surgery: a narrative review of abdominal emergency management for general surgeons. Minerva Surg 2024; 79:629-647. [PMID: 39932466 DOI: 10.23736/s2724-5691.24.10536-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2025]
Abstract
Minimally invasive approaches like endoscopic, laparoscopic, and robotic surgery have revolutionized bariatric and metabolic surgery (MBS). Despite the safety of MBS in specialized centers, acute complications requiring emergency treatment may occur and present challenges for general surgeons, especially in community hospitals. This is further complicated by the rising popularity of bariatric surgery tourism and the increasing diversity of bariatric surgical techniques. This paper provides an updated review of the management of acute abdominal complications after minimally invasive MBS, intending to guide general surgeons in managing these patients, especially in emergency settings where specialized bariatric care may not be readily available.
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Affiliation(s)
- Niccolò Petrucciani
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Francesco M Carrano
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy -
| | - Sara C Barone
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Marta Goglia
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Erika Iadicicco
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Gabriella Distefano
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Leonida Mucaj
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Silvia Stefanelli
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Francesco D'Angelo
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Paolo Aurello
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
| | - Gianfranco Silecchia
- Department of Medical, Surgical Sciences and Translational Medicine, Sapienza University, Rome, Italy
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Romero R, Biliauws L, Roussel J, Catheline JM. Complications resulting from an intragastric balloon in a patient without follow-up and monitoring. BMJ Case Rep 2024; 17:e258434. [PMID: 39317487 PMCID: PMC11423757 DOI: 10.1136/bcr-2023-258434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 09/12/2024] [Indexed: 09/26/2024] Open
Abstract
The intragastric balloon (IGB) is recognised as a minimally invasive intervention for the treatment of obesity. Here, we detail a rare and life-threatening complication stemming from this procedure. A female patient in her 40s, who had an IGB in situ for 14 months, presented at the emergency department with septic shock characterised by abdominal guarding and emesis. These symptoms were a direct result of IGB-induced bowel obstruction. We emphasise that the patient missed the recommended 6-month removal window, which in our opinion is the decisive cause leading to deflated balloon migration and subsequent complications. In the course of managing multiple critical events, the patient required multiple operations related to the bowel obstruction, numerous nutritional and psychological challenges. Currently, the patient is living with short bowel syndrome, secondary to the chronic intestinal failure, necessitating the administration of parenteral nutrition 6 days per week.
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Affiliation(s)
- Rodolfo Romero
- Department of Digestive Surgery, Centre Hospitalier de Saint Denis, Saint Denis, France
| | - Lore Biliauws
- Gastroenterology MICI Nutrition Assistance, APHP, Clichy, France
| | - Joel Roussel
- Department of Digestive Surgery, Centre Hospitalier de Saint Denis, Saint Denis, France
| | - Jean-Marc Catheline
- Department of Digestive Surgery, Centre Hospitalier de Saint Denis, Saint Denis, France
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Prior-Rosas JE, Magaña-Salcedo JR, Gutiérrez-Olivares OM, Canet Atilano AJ, Lomeli Reyes D. Esophageal laceration after failed endoscopic intragastric ballon retrieval and open approach treatment case report. Int J Surg Case Rep 2024; 122:110137. [PMID: 39128213 PMCID: PMC11359964 DOI: 10.1016/j.ijscr.2024.110137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Revised: 07/31/2024] [Accepted: 08/07/2024] [Indexed: 08/13/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE The intragastric ballon (IGB) is an minimal invasive alternative treatment of weight loss, it has a rate of complications of 2.8-5.5 %. This case highlights the importance of surveillance of the patients to prevent further complications. CASE REPORT We present a case of a 43 years old women with IMC of 31.25 kg/m2 and diabetes mellitus background, who underwent to insertion of intragastric ballon, unfortunately the patient lost the follow up with the endoscopy without surveillance and remain with the intragastric ballon for 9 months. The patient started to experience abdominal pain, vomit and oral intolerance so the patient attended to the endoscopist to evaluate the cause of her symptoms. The patient was brought to the endoscopy where the retrieval was not successful. The patient is brought to the emergency room for surgical extraction. DISCUSSION Given the high cost, complication risk and invasiveness of bariatric surgery, intragastric ballon treatment may present a safer and lower cost option for weight reduction. Most of the available IGB are recommended time for gastric ballon removal is 6-12 months, with the appropriate surveillance. In our case it was not possible to endoscopic retrieval due malfunction of the Spatz-3's valve, thickening wall and its partial migration towards the fundus and cardia which causes an esophageal laceration and gastric bleeding. CONCLUSION Mandatory education and accreditation of physicians dealing with bariatric endoscopy and strict supervision of obese individuals throughout the time they have the balloon in their stomachs will eliminate most complications.
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Affiliation(s)
| | | | | | - Alejandro Jiménez Canet Atilano
- Department of Surgery, General Hospital, Dr. Darío Fernández Fierro ISSSTE, Mexico; Department of Endoscopy, General Hospital, Dr. Darío Fernández Fierro ISSSTE, Mexico
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Coelho DL, Amaral RC, Silva IC, Oliveira AVOB, Neto AS, Silva JFP, Joviano-Santos JV. Realistic simulation and medical students' performance in the Advanced Cardiac Life Support course: a comparative study. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:61-68. [PMID: 37994405 DOI: 10.1152/advan.00113.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Clinical practice has benefited from new methodologies such as realistic simulation (RS). RS involves recreating lifelike scenarios to more accurately reflect real clinical practice, enhancing learners' skills and decision-making within controlled environments, and experiencing remarkable growth in medical education. However, RS requires substantial financial investments and infrastructure. Hence, it is essential to determine the effectiveness of RS in the development of skills among medical students, which will improve the allocation of resources while optimizing learning. This cross-sectional study was carried out in the simulation laboratory of a medical school, and the performance of students who underwent two different curriculum matrices (without RS and with RS, from 2021 to 2022) in the Advanced Cardiac Life Support (ACLS) course was compared. This test was chosen considering that the competencies involved in cardiac life support are essential, regardless of the medical specialty, and that ACLS is a set of life-saving protocols used worldwide. We observed that the impact of RS can be different for practical abilities when compared with the theoretical ones. There was no correlation between the general academic performance and students' grades reflecting the RS impact. We conclude that RS leads to less remediation and increased competence in practical skills. RS is an important learning strategy that allows repeating, reviewing, and discussing clinical practices without exposing the patient to risks.NEW & NOTEWORTHY Realistic simulation (RS) positively affected the performance of the students differently; it had more influence on practical abilities than theoretical knowledge. No correlation between the general academic performance and grades of the students without RS or with RS was found, providing evidence that RS is an important tool in Advanced Cardiac Life Support education.
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Affiliation(s)
- Débora L Coelho
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Rosana C Amaral
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Isabella C Silva
- Student of the Course in Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ana Virgínia O B Oliveira
- Student of the Course in Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Augusto Scalabrini Neto
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - José Felippe P Silva
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Julliane V Joviano-Santos
- Post-Graduate Program in Health Sciences, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
- Laboratório de Investigações NeuroCardíacas, Ciências Médicas de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Martins MF, De la Hoz Gomez A, Manivannan A, Shapira‐Daniels A, Campbell Reardon CL. Gastric outlet obstruction due to an intragastric balloon in a patient returning from the Caribbean. Clin Case Rep 2024; 12:e8509. [PMID: 38333653 PMCID: PMC10849985 DOI: 10.1002/ccr3.8509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 02/10/2024] Open
Abstract
Key Clinical Message Gastric outlet obstruction can be a dangerous complication of intragastric balloons, as it can result in severe metabolic alkalosis. As weight loss procedures and medical tourism become more popular, physicians should have a high index of suspicion for complications of invasive procedures, particularly in returning travelers. Abstract Intragastric balloons for weight loss have decreased in frequency in the United States. However, they are still frequent in low- and middle-income countries. Severe complications occur in less than 3% of patients who undergo this procedure. Herein, we present a case of gastric outlet obstruction, severe metabolic alkalosis, and refeeding syndrome in a patient returning from the Dominican Republic. She presented with 2 weeks of emesis and obstipation, followed by a pre-syncope and altered mental status. An intragastric mass was observed on computerized tomography, which was characterized as an intragastric balloon and retrieved endoscopically. All metabolic derangements were corrected, and the patient improved without sequelae. As weight loss procedures and medical tourism become more popular, physicians should have a high index of suspicion for complications of invasive procedures, particularly in returning travelers.
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Das SS, Bondok W, Jafri IF, Ghazi DA, AbdelAziz Z. Acute Necrotizing Pancreatitis Following Intragastric Balloon Insertion. Cureus 2024; 16:e54437. [PMID: 38510873 PMCID: PMC10951778 DOI: 10.7759/cureus.54437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Abstract
Obesity has become a widespread global issue, particularly in the developed world. One popular weight loss technique is the intragastric balloon placement due to its simplicity of insertion and safe nature. While some side effects have been linked to its use, most are benign. However, severe complications do occur in some cases. One such rare complication is pancreatitis due to compression of the pancreas or the pancreatic duct. We encountered an interesting case of necrotizing pancreatitis following gastric balloon insertion, about which scarce data is available in the literature; its incidence is also unknown currently. Our patient was a 22-year-old male with a gastric balloon inserted for obesity eight months before his presentation. The mechanism of the inflammation, the age of the patient, and the progression to necrosis are the compelling aspects of this case.
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Affiliation(s)
| | | | - Iqra F Jafri
- General Surgery, Dubai Medical College, Dubai, ARE
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Foula MS, Amer NM, Zakaria H, Ismail MH, Alshomimi SJ, Al Bisher HM, Alsaleem H, Almulhim K, Aldabaeab AE, Alratrout H, Alsadery HA, Alarfaj MA, Aljehani YM, El Damati AM. Surgical Management of Intra-gastric Balloon Complications, Single-Center Experience, and Literature Review. Obes Surg 2023; 33:2718-2724. [PMID: 37452985 DOI: 10.1007/s11695-023-06716-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 06/24/2023] [Accepted: 06/28/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION In Saudi Arabia, the prevalence of obesity has multiplied in the last decades leading to a surge in bariatric surgery and other endoscopic modalities. The intra-gastric balloon (IGB) is the most used endoscopic modality. Surgical management for IGB complications is required for gastrointestinal perforation and/or obstruction. However, the literature seems to underestimate these complications. MATERIALS AND METHODS A retrospective descriptive study was conducted in King Fahd University Hospital, Saudi Arabia, from Jan 2017 to Dec 2021, including all patients with complicated IGB who necessitated any surgical procedure. Exclusion criteria were patients with complicated IGBs that were only managed conservatively or endoscopically. RESULTS A total of 326 patients were admitted with different complications after bariatric procedures. Of them, six patients were referred due to IGB complications that necessitated operative intervention. All patients were young females. Three patients had gastric wall perforation, and were managed by endoscopic removal of the IGBs followed by exploratory laparotomy. One patient had an intestinal obstruction on top of a migrated IGB that was surgically removed. One patient had failed endoscopic retrieval of IGB and required a laparoscopic gastrostomy. Another patient had an esophageal rupture that required left thoracotomy, pleural flap, and insertion of an esophageal stent. All cases were discharged and followed up with no related complications. CONCLUSION IGB is an endoscopic alternative, within specific indications, for the management of obesity. However, surgical management may be necessary to manage its complications, including gastrointestinal perforation, IGB migration, and failure of endoscopic removal.
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Affiliation(s)
- Mohammed S Foula
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia.
| | - Nasser M Amer
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hazem Zakaria
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Mona H Ismail
- Division of Gastroenterology, Department of Internal Medicine, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Saeed J Alshomimi
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hassan M Al Bisher
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hassan Alsaleem
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Khalifa Almulhim
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Abdulaziz E Aldabaeab
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Hefzi Alratrout
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Humood A Alsadery
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Mosab A Alarfaj
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Yasser M Aljehani
- Department of Surgery, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia
| | - Ahmed M El Damati
- Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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Molina GA, Rojas C, Aguayo W, Vivar C, Guzmán JD. Perforated gastric ulcer after unhealthy decisions in a patient with an intragastric balloon, a hangover you will regret. Surg Case Rep 2023; 9:47. [PMID: 36971911 PMCID: PMC10043066 DOI: 10.1186/s40792-023-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Perforated gastric ulcers are life-threatening surgical emergencies that need early diagnosis and treatment to overcome severe complications. With the rise of obesity in recent years, intragastric balloons have arisen as a "safe" strategy; however, in medicine, no treatment is risk-free. Nausea, pain, vomiting, and more severe complications like perforation, ulceration, and death can occur. CASE PRESENTATION We present the case of a 28-year-old man with obesity; treatment with an intragastric balloon was initiated with good results at the beginning of his treatment. However, he neglected his treatment over time and made unhealthy choices, leading to a severe complication. However, thanks to prompt surgical treatment, he made a full recovery. COMPLICATIONS Gastric perforation following an intragastric balloon is a severe and potentially life-threatening complication that an experienced multidisciplinary team must treat promptly and, more importantly, prevent.
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Affiliation(s)
- Gabriel A Molina
- Digeslap Center & Universidad San Francisco de Quito (USFQ), Quito, Ecuador.
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Alkhathami AA, Ahmed ZB, Alkhushayl AM, Alsaffar F, Alshahrani AM. Acute pancreatitis after intragastric balloon insertion: case report. J Surg Case Rep 2023; 2023:rjad093. [PMID: 36896167 PMCID: PMC9991575 DOI: 10.1093/jscr/rjad093] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/05/2023] [Indexed: 03/09/2023] Open
Abstract
The intragastric balloon (IGB) is a relatively recent non-surgical weight loss technique that is now widely used in the world to treat obesity. However, IGB causes a wide range of adverse effects that range from minor ones, such as nausea, stomach pain and gastroesophageal reflux, to serious ones, such as ulceration, perforation, intestinal blockage and compression of adjusting structures. A 22-year-old Saudi woman presented to the emergency department (ED) with a history of upper abdominal pain that started 1 day before admission. The patient's surgical background was unremarkable, and no other obvious pancreatitis risk factors were present. The patient underwent a minimally invasive treatment after being diagnosed with obesity (class 1), in which an IGB was inserted one and a half months prior to her ED presentation. She consequently began to lose weight (around 3 kg). The hypothesis states that pancreatitis following IGB insertion can be caused either by stomach distention and pancreatic compression at the tail or body or by ampulla obstruction due to balloon catheter migration at the duodenum. Heavy meal consumption, which may cause an increase in pancreatic compression, is another potential cause of pancreatitis in such patients. We believe that the IGB-induced compression of the pancreas at its tail or body was the likely cause of pancreatitis in our case. This case was reported because it is the first one from our city as far as we know. A few cases from Saudi Arabia have also been reported, and reporting them will help to improve doctors' awareness of this complication, which can cause pancreatitis symptoms to be mistaken for something else because of the balloon-related effects on gastric distention.
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Affiliation(s)
| | - Zuhair Babiker Ahmed
- Bariatric & Metabolic Surgery Unit, Department of General Surgery, King Abdullah Hospital, Bisha, Saudi Arabia
| | | | - Faiz Alsaffar
- Bariatric & Metabolic Surgery Unit, Department of General Surgery, King Abdullah Hospital, Bisha, Saudi Arabia
| | - Abdullah M Alshahrani
- Department of Family Medicine, College of Medicine, University of Bisha, Bisha, Saudi Arabia
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Outcomes and Trends of Endoscopic Bariatric Therapies (EBT) Among Minority Populations. Obes Surg 2023; 33:513-522. [PMID: 36477696 DOI: 10.1007/s11695-022-06399-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Endoscopic bariatric therapies (EBT) have emerged as effective options for weight loss. While the benefits of EBT have been documented, data regarding such therapies among minority populations remains scant. We aim to investigate EBT trends and outcomes in minority populations. METHODS Data were extracted from the 2015 to 2019 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Project (MBSAQIP) databases. Intragastric balloon (IGB) and endoscopic sleeve gastroplasty (ESG) cases were identified, and procedure volume assessed by year and race/ethnicity. Measures of interest included year-to-year mortality, surgical complications, and 30-day adverse outcomes. RESULTS Of 966,646 cases in the MBSAQIP databases, 5209 (0.54%) IGB and ESG cases were included. 10.7% were black, and 81.6% were female patients. Compared to white patients, black and Hispanic patients were younger (p < 0.01) with a higher body mass index (p < 0.001). Mortality (0.03% vs. 0% vs. 0%, p = 0.99), reoperation (1.1% vs. 0.8% vs. 0.6%, p = 0.30), and reintervention (3.9% vs. 3.2% vs. 2.3%, p = 0.09) rates were similar between racial/ethnic cohorts. All complications were similar between racial/ethnic cohorts, except a higher rate of venous thromboembolism, in Hispanic (1.04%, p < 0.01) compared to black (0.18%) and white (0.21%) patients. IGB and ESG were predominantly performed in white and Hispanic patients, respectively. ESG was associated with a higher leak (0.6% vs. 0.02%, p < 0.01) and venous thromboembolism (VTE) (1.0% vs. 0.12%, p < 0.01) rate. CONCLUSION While EBTs have increased annually, they are performed less in black patients. Future studies are needed to identify access barriers for black patients. They are safely performed with similar outcomes in racial/ethnic cohorts, except for a higher VTE rate in Hispanic patients.
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Liu X, Wu Y, Liu C, Chen K, Gregersen H. Development of an Ingestible Expandable Capsule for Weight Loss. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16821. [PMID: 36554702 PMCID: PMC9779746 DOI: 10.3390/ijerph192416821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 12/04/2022] [Accepted: 12/10/2022] [Indexed: 06/17/2023]
Abstract
Obesity has grown to epidemic proportions with 2.1 billion people being overweight worldwide. A food-grade expandable capsule named EndoXpand for the treatment of overweight people was designed and developed in this study. EndoXpand consists of an inner expandable material (core), an embracing membrane, and a gelatin capsule shell. It is designed to occupy volume in the stomach and reduce hunger sensation. The occupied volume is changeable over time, dependent on the number of ingested capsules and their degradation time. This will avoid gastric accommodation to constant volume devices as seen in the use of intragastric balloons. Several materials were tested. Collagen casing was selected as the membrane and corn silk was used to tie the membrane. Dried black fungus (Auricularia auricula) was the biological material that expanded most. However, synthesized cellulose-based hydrogel expanded more and was chosen as the optimal expandable core material. The hydrogel-based EndoXpand expanded 72 times after soaking in an acidic environment for 80 min. The corn silk ligations weakened and broke after 3 h. This resulted in release of the expanded material that was designed to easily pass the pylorus and travel down the intestine for digestion or excretion. In conclusion, this study provides design and in vitro proof-of-technology data for a potential groundbreaking approach. Further studies are needed in animal models and human phase I studies.
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Affiliation(s)
- Xingyu Liu
- Graduate School, Chongqing Normal University, Chongqing 401331, China
| | - Yeung Wu
- Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong 999077, China
| | - Chang Liu
- Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong 999077, China
| | - Kaiqi Chen
- Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong 999077, China
| | - Hans Gregersen
- GIOME, California Medical Innovations Institute, San Diego, CA 92121, USA
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12
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Mapping of Intragastric Balloon Use: a Guide to the Activity of Institutions Through Bibliometry. Obes Surg 2022; 32:2373-2385. [PMID: 35501633 DOI: 10.1007/s11695-022-06089-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Bibliometric analysis is an effective method for measuring scientific contributions in a variety of fields. It enables the numerical analysis of publications in a specific field and period of time, as well as the relationships between these publications. The present bibliometric analysis of publications relating to obesity treatment by means of intragastric balloons aimed to identify the bariatric centers using intragastric balloons, through the publications relating to their productivity; and furthermore, to reveal collaborations, types of balloons used, number of patients involved, and authors' productivity and favored journals. METHOD The PubMed and Scopus databases were used to retrieve only original articles presenting the results in body weight reduction. RESULTS Bibliographic research identified 164 publications for the period 2000-2021. Italy was ranked first with 37 publications; USA participated as collaborator with 9 different countries; the fluid-filled Orbera balloon is featured in 126 publications; the journal Obesity Surgery hosted 86 publications; Brazil reported the greatest number of patients with 5874 cases; Lorenzo M and Genco A, co-authors from Italy, authored 14 and 12 publications, respectively, and the most cited article was that of Genco et al. [2007] with 441 citations. CONCLUSIONS Bibliometric analysis gave us the opportunity to identify the centers through their scientific publications and to classify them in relation to their productivity in articles, in collaborations, in number of cases reported, and in the number of citations gained.
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Keßler R, Glitsch A, Hübner B, Gärtner S, Steveling A, Patrzyk M, Keßler W. Abdominal Morphologic Changes in MRI during Gastric Balloon Therapy. Obes Facts 2022; 15:703-710. [PMID: 35973414 PMCID: PMC9669953 DOI: 10.1159/000526444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 07/28/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Adiposity and excessive weight are on the rise in western industrialized countries. In cases where conservative measures fail and surgical interventions are not (yet) desired, gastric balloon therapy has proven to be a safe and reversible endoscopic method. METHODS Aside from weight progression under gastric balloon therapy and by using MRI, our research paper describes the behavior of different abdominal body fat compartments at the beginning and at the end of the gastric balloon therapy. Additionally, the volume of the left liver lobe as well as the fill volume and performance of the gastric balloon were analyzed over the duration of treatment. For assessing potential impacts of weight reduction on the muscle mass, we determined the area of the m. psoas on a comparable cross-sectional area at the beginning and at the end of the therapy. RESULTS We were able to verify a significant reduction of the layer of subcutaneous fat, adipose capsule of the kidney, and intra-abdominal fatty tissue during the therapy. The volume of the left liver lobe was shrinking in addition to a muscle loss during the balloon therapy. The volume of the gastric balloon remained stable (not hyperinflation). There were variable gas bubbles in the gastric balloon. CONCLUSION The gastric balloon is a temporary and successful option for weight reduction by reducing body fat, liver volume, but also muscle mass.
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Affiliation(s)
- Rebecca Keßler
- Department of Diagnostic Radiology and Neuroradiology, University Medical Center Greifswald, Greifswald, Germany
| | - Anne Glitsch
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Björn Hübner
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Simone Gärtner
- Department of Internal Medicine A, University Medical Center Greifswald, Greifswald, Germany
| | - Antje Steveling
- Department of Internal Medicine A, University Medical Center Greifswald, Greifswald, Germany
| | - Maciej Patrzyk
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Wolfram Keßler
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
- *Wolfram Keßler,
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Patrzyk M, Sonke J, Glitsch A, Kessler R, Steveling A, Lünse S, Partecke LI, Heidecke CD, Kessler W. Gastric Balloon Implantation as Part of Morbid Adiposity Therapy Changes the Structure of the Stomach Wall. Visc Med 2021; 37:418-425. [PMID: 34722725 PMCID: PMC8543320 DOI: 10.1159/000514264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 01/04/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The implantation of a gastric balloon (also known as intragastric balloon) is an established and reversible endoscopic procedure for adiposity therapy. Structural changes of the stomach wall are expected to occur with gastric balloon implantation; however, until now these changes have rarely been investigated. METHODS We compared the histological structure of the stomach wall after gastric-sleeve resection in a group of patients following gastric balloon implantation and a group without previous gastric balloon implantation. RESULTS Following gastric balloon implantation, the tunica muscularis was found to be significantly thicker than without gastric balloon implantation. The enlarging of the tunica muscularis is not caused by hyperplasia of the leiomyocytes, but by hypertrophy of the leiomyocytes and an increase in collagen fibers (fibrosis). CONCLUSION A longer-lasting hypertrophy of the tunica muscularis, particularly in the corpus, should be taken into account when surgical treatment follows gastric balloon implantation. The staple suture height should be adjusted to the altered tissue composition since reduced tissue elasticity must be expected due to fibrosis.
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Affiliation(s)
- Maciej Patrzyk
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Jenny Sonke
- Department of Pathology, University Medical Center Greifswald, Greifswald, Germany
| | - Anne Glitsch
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Rebecca Kessler
- Department of Diagnostic Radiology and Neuroradiology, University Medical Center Greifswald, Greifswald, Germany
| | - Antje Steveling
- Department of Internal Medicine A, University Medical Center Greifswald, Greifswald, Germany
| | - Sebastian Lünse
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Lars Ivo Partecke
- Department of General, Visceral and Thoracic Surgery, Helios-Klinikum Schleswig, Schleswig, Germany
| | - Claus-Dieter Heidecke
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
| | - Wolfram Kessler
- Department of General, Visceral, Thoracic and Vascular Surgery, University Medical Center Greifswald, Greifswald, Germany
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Abstract
PURPOSE OF REVIEW To provide updated evidence on the endoscopic procedures for weight loss and to bring personal insights on the future of endobariatrics. RECENT FINDINGS Intragastric balloons promote significant improvement in histologic and radiologic aspects of non-alcoholic steatohepatitis; the endoscopic sleeve gastroplasty is effective up to 5 years and seems particularly beneficial to patients with BMI≤40kg/m2; distal POSE is a promising technique but still lacks adequate clinical data; aspiration therapy triggers remarkable weight loss, but data on weight trends after removal of the device are still lacking; the satiety-inducing device, the sleeveballoon, the gastric mucosal devitalization, and the endoscopic magnetic partial jejunal diversion are promising procedures still under study and refinements. Several therapeutic options are necessary during obesity's natural history. Therefore, endobariatrics should act in harmony with lifestyle interventions, diet modification, psychological treatment, pharmacotherapy, and bariatric surgery seeking the best outcome in the long term.
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Affiliation(s)
- Vitor Ottoboni Brunaldi
- Gastrointestinal Endoscopy Unit, Gastroenterology Department, University of São Paulo Medical School, Eneas de Carvalho Aguiar Av. 255, São Paulo, SP, 05304-000, Brazil.
- Surgery and Anatomy Department, Division of Gastrointestinal Surgery, Faculty of Medicine of Ribeirão Preto, Ribeirão Preto, Brazil.
| | - Manoel Galvao Neto
- Department of Surgery, ABC Faculty of Medicine, Santo Andre, Brazil
- Endovitta Institute, Sao Paulo, Brazil
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16
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Stavrou G, Shrewsbury A, Kotzampassi K. Six intragastric balloons: Which to choose? World J Gastrointest Endosc 2021; 13:238-259. [PMID: 34512874 PMCID: PMC8394181 DOI: 10.4253/wjge.v13.i8.238] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/17/2021] [Accepted: 07/13/2021] [Indexed: 02/06/2023] Open
Abstract
Endoscopically placed intragastric balloons (IGBs) have played a significant role in obesity treatment over the last 30 years, successfully bridging the gap between lifestyle modification/pharmacotherapy and bariatric surgery. Since they provide a continuous sensation of satiety that helps the ingestion of smaller portions of food, facilitating maintenance of a low-calorie diet, they have generally been considered an effective and reversible, less invasive, non-surgical procedure for weight loss. However, some studies indicate that balloons have limited sustainable effectiveness for the vast majority attempting such therapy, resulting in a return to the previous weight after balloon removal. In this review we try to summarize the pros and cons of various balloon types, to guide decision making for both the physician and the obese individual looking for effective treatment. We analyzed the six most commonly used IGBs, namely the liquid-filled balloons Orbera, Spatz3, ReShape Duo and Elipse, and the gas-filled Heliosphere and Obalon - also including comments on the adjustable Spatz3, and the swallowable Obalon and Elipse - to optimize the choice for maximum efficacy and safety.
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Affiliation(s)
- George Stavrou
- Department of Colorectal Surgery, Addenbrooke’s Hospital, Cambridge CB22QQ, United Kingdom
| | - Anne Shrewsbury
- Department of Surgery, Endoscopy Unit, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
| | - Katerina Kotzampassi
- Department of Surgery, Endoscopy Unit, Aristotle University of Thessaloniki, Thessaloniki 54636, Greece
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17
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Staudenmann DA, Sui Z, Saxena P, Kaffes AJ, Marinos G, Kumbhari V, Aepli P, Sartoretto A. Endoscopic bariatric therapies for obesity: a review. Med J Aust 2021; 215:183-188. [PMID: 34333788 DOI: 10.5694/mja2.51179] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
▪ Obesity is reaching pandemic proportions globally, with overweight or obesity affecting at least two-thirds of Australian adults. ▪ Bariatric surgery is an effective weight loss strategy but is constrained by high resource requirements and low patient acceptance. ▪ Multiple endoscopic bariatric therapies have matured, with well established and favourable safety and efficacy profiles in multiple randomised controlled trials (RCTs), and are best used within a multidisciplinary setting as an adjuvant to lifestyle intervention. ▪ Three types of intragastric balloon are currently in use in Australia offering average total weight loss ranging from 10% to 18%, with others available internationally. ▪ Endoscopic sleeve gastroplasty produces average total weight loss of 15-20% with low rates of severe complications, with RCT data anticipated in December 2021. ▪Bariatric and metabolic endoscopy is rapidly evolving, with many novel, promising therapies currently under investigation.
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Affiliation(s)
- Dominic A Staudenmann
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW.,Praxis Balsiger Seibold und Partner, Bern, Switzerland.,Université de Fribourg, Fribourg, Switzerland
| | | | | | - Arthur J Kaffes
- AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, Sydney, NSW
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18
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The Efficacy and Safety of a Procedureless Gastric Balloon for Weight Loss: a Systematic Review and Meta-Analysis. Obes Surg 2021; 30:3341-3346. [PMID: 32266698 DOI: 10.1007/s11695-020-04522-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intragastric balloons have been used to bridge the obesity treatment gap with the benefits of being minimally invasive but still required endoscopy. The Elipse intragastric balloon (EIGB) is a swallowable balloon that is spontaneously excreted through a natural orifice at approximately 16 weeks. Several concerns exist, including the treatment efficacy and risk of bowel obstruction. Our meta-analysis aimed to evaluate the efficacy and safety of EIGB. METHODS A literature search was performed from several databases from database inception to November 2019. Eligible studies must report percent total weight loss (%TWL) after completion of treatment and adverse events. The pooled means and proportions of our data were analyzed using random effects model, generic inverse variance method. RESULTS Six studies involving 2013 unique patients met our eligibility criteria and were included. The mean baseline BMI ranged from 30.6 to 36.2. The pooled early removal rate was 2.3% (95% CI, 1.1-3.5%; I2 31%). The pooled %TWL after completion of treatment (4-6 months) was 12.8% (95% CI, 11.6-13.9%; I2 83%) and at 12 months was 10.9% (95% CI, 5.0-16.9%, I2 98%). For serious adverse events, three patients had small bowel obstruction, and one patient had gastric perforation requiring surgery. Early expulsion by emesis and early deflation were seen in 3 and 9 patients, respectively. CONCLUSIONS This meta-analysis demonstrates that EIGB is a safe device offering an effective weight loss that warrants further studies for its long-term weight loss outcomes. Severe adverse events are rare, and the rate of early removal is low.
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19
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Lari E, Burhamah W, Lari A, Alsaeed T, Al-Yaqout K, Al-Sabah S. Intra-gastric balloons - The past, present and future. Ann Med Surg (Lond) 2021; 63:102138. [PMID: 33664941 PMCID: PMC7903294 DOI: 10.1016/j.amsu.2021.01.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/23/2021] [Indexed: 01/28/2023] Open
Abstract
Obesity is a complex metabolic illness that is interrelated to a plethora of complications that predispose to avoidable morbidity and mortality. The considerable impact of obesity has invited various therapies ranging from lifestyle advice, pharmacotherapy, endoscopic bariatric therapy and ultimately surgery. Intragastric balloons are space-occupying therapies that aim to increase satiety through mechanical and neuroendocrine mechanisms. Their prevalence is owed to their ease of administration and general safety. However, long term data concerning safety and efficacy is scarce when considering the various types of balloons in use. In this review, we discuss the intragastric balloon comprehensively in terms of efficacy, safety, limitations and future direction.
A rise in the prevalence of obesity is evident. There is a continuous drive towards non-invasive management. Intra-gastric balloons are a valuable adjunct for the management of obesity. Promising outcomes are evident especially in combination with lifestyle modification and pharmacotherapy.
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20
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Djelil D, Taihi L, Cattan P. Migration of an intragastric balloon may necessitate enterotomy for extraction. J Visc Surg 2020; 158:185-186. [PMID: 33168475 DOI: 10.1016/j.jviscsurg.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Intragastric balloon (IGB) placement for the treatment of obesity is presented as a non-invasive and safe technique leading to significant weight loss. We report a case of an IGB migration that led to small bowel occlusion. Radiological analysis confirmed impaction at 250cm from the angle of Treitz. Enterotomy was necessary to treat the occlusion.
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Affiliation(s)
- D Djelil
- Visceral, oncologic and endocrine surgery department, Saint-Louis Lariboisière hospital center, AP-HP, 75010 Paris, France.
| | - L Taihi
- Osteoarticular imaging service, Lariboisière hospital, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France
| | - P Cattan
- Visceral, oncologic and endocrine surgery department, Saint-Louis Lariboisière hospital center, AP-HP, 75010 Paris, France
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21
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Modelling and manufacturing of 3D-printed, patient-specific, and anthropomorphic gastric phantoms: a pilot study. Sci Rep 2020; 10:18976. [PMID: 33149133 PMCID: PMC7643145 DOI: 10.1038/s41598-020-74110-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 09/23/2020] [Indexed: 11/19/2022] Open
Abstract
Interventional devices including intragastric balloons are widely used to treat obesity. This study aims to develop 3D-printed, patient-specific, and anthropomorphic gastric phantoms with mechanical properties similar to those of human stomach. Using computed tomography gastrography (CTG) images of three patients, gastric phantoms were modelled through shape registration to align the stomach shapes of three different phases. Shape accuracies of the original gastric models versus the 3D-printed phantoms were compared using landmark distances. The mechanical properties (elongation and tensile strength), number of silicone coatings (0, 2, and 8 times), and specimen hardness (50, 60, and 70 Shore A) of three materials (Agilus, Elastic, and Flexa) were evaluated. Registration accuracy was significantly lower between the arterial and portal phases (3.16 ± 0.80 mm) than that between the portal and delayed phases (8.92 ± 0.96 mm). The mean shape accuracy difference was less than 10 mm. The mean elongations and tensile strengths of the Agilus, Elastic, and Flexa were 264%, 145%, and 146% and 1.14, 1.59, and 2.15 MPa, respectively, and their mechanical properties differed significantly (all p < 0.05). Elongation and tensile strength assessments, CTG image registration and 3D printing resulted in highly realistic and patient-specific gastric phantoms with reasonable shape accuracies.
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22
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Kolli S, Ofosu A, Gurram H, Weissman S, Dang‐Ho PK, Mehta TI, Gill H, Gurram KC. Hidden dangers and updated labels on gastric balloons. Clin Case Rep 2020; 8:2116-2120. [PMID: 33235739 PMCID: PMC7669380 DOI: 10.1002/ccr3.2730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 01/16/2020] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
In recent years, intragastric balloons (IGBs) have emerged as an efficacious, nonsurgical modality to treat obesity. We present a case in which an IGB caused a gastric ulcer, only unearthed after the novel technique of deflation and early retrieval.
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Affiliation(s)
- Sindhura Kolli
- Department of Medicine, NYU Langone Comprehensive Program on ObesityNYU Grossman School of MedicineNew YorkNYUSA
| | - Andrew Ofosu
- Department of Gastroenterology and HepatologyThe Brooklyn Hospital CenterBrooklynNYUSA
| | - Harini Gurram
- Department of Internal MedicineNorthwestern UniversityChicagoILUSA
| | - Simcha Weissman
- Department of Internal MedicineHackensack University‐Palisades Medical CenterNorth BergenNJUSA
| | - Paul Khoi Dang‐Ho
- Department of Medicine, NYU Langone Comprehensive Program on ObesityNYU Grossman School of MedicineNew YorkNYUSA
| | - Tej I. Mehta
- Department of MedicineSouth Dakota Sanford School of MedicineSioux FallsSDUSA
| | - Hailie Gill
- Department of Gastroenterology and HepatologyThe Brooklyn Hospital CenterBrooklynNYUSA
| | - Krishna C. Gurram
- Department of Gastroenterology and HepatologyThe Brooklyn Hospital CenterBrooklynNYUSA
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23
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Brunaldi VO, Galvao Neto M. Gastric space-occupying devices for management of obesity and metabolic disease. ACTA ACUST UNITED AC 2020. [DOI: 10.1016/j.tige.2020.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Orlandini B, Gallo C, Boškoski I, Bove V, Costamagna G. Procedures and devices for bariatric and metabolic endoscopy. Ther Adv Gastrointest Endosc 2020; 13:2631774520925647. [PMID: 32548577 PMCID: PMC7271273 DOI: 10.1177/2631774520925647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 04/21/2020] [Indexed: 12/14/2022] Open
Abstract
Obesity is a leading cause of preventable death in developed countries, with a
rising incidence over time. Lifestyle modification, pharmacotherapy, and
bariatric surgery are the mainstays of bariatric therapy, even though burdened
by several limitations in terms of efficacy or safety. Bariatric endoscopy has
been developed in the last decades as a minimally invasive alternative, aimed to
bridge the gap between conservative and interventional conventional therapies.
This review aims to provide an updated overview of the bariatric and metabolic
available endoscopic procedures and to drive the choice of the right procedure
for the right patient.
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Affiliation(s)
- Beatrice Orlandini
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Camilla Gallo
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Ivo Boškoski
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo A. Gemelli, 8 00168 Rome, Italy
| | - Vincenzo Bove
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Guido Costamagna
- Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
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Jeong Y, Lee J, Kim KA, Park CM. Medical Devices of the Abdomen and Pelvis and Their Complications: A Radiologic Atlas. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:863-885. [PMID: 36238189 PMCID: PMC9432218 DOI: 10.3348/jksr.2020.81.4.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/30/2019] [Accepted: 10/20/2019] [Indexed: 11/15/2022]
Abstract
의료기구들이 발달하면서 복부 및 골반 내에 이식되거나 거치되는 의료기구들이 다양해졌다. 흔하게 사용되는 기구들의 영상의학 소견은 영상의학과 의사들에게 매우 익숙하지만, 상대적으로 사용 빈도가 낮거나 새로운 형태의 기구들의 영상의학 소견은 잘 알려져 있지 않다. 또한 환자에 대한 임상정보가 제한적일 경우 이런 새로운 형태의 의료기구들은 잘못 해석되거나 놓치기 쉽다. 그러므로 복부 및 골반 내 의료기구들의 영상의학 소견을 인지하는 것은 기구들의 올바른 위치를 평가하고, 이와 관련된 합병증을 평가하는데 있어 매우 중요하다. 본 논문에서는 다양한 복부 및 골반 내 의료기구들과 이와 관련된 합병증의 영상의학 소견을 소개하고자 한다.
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Affiliation(s)
- Yaewon Jeong
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jongmee Lee
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Ah Kim
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Cheol Min Park
- Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
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