Effect of Laparoscopic Adjustable Gastric Banding on Metabolic Syndrome and Its Risk Factors in Morbidly Obese Adolescents

We examined the effect of laparoscopic adjustable gastric banding (LAGB) on weight loss, inflammatory markers, and components of the Metabolic Syndrome (MeS) in morbidly obese adolescents and determined if those with MeS lose less weight post-LAGB than those without. Data from 14–18 yr adolescents were obtained at baseline, 6 and 12 months following LAGB. Significant weight loss and improvements in MeS components were observed 6 months and one year following LAGB. The incidence of MeS declined 56.8% after 6 months and 69.6% after 12 months. There was no significant difference in amount of weight lost post-LAGB between those with and without MeS at either timepoint. Correlations between change in weight parameters and components of MeS in those with and without MeS at baseline were examined and found to vary by diagnostic category. LAGB is effective for short-term improvement in weight, inflammatory markers, and components of MeS in morbidly obese adolescents

Effect of Laparoscopic Adjustable Gastric Banding on Metabolic Syndrome and Its Risk Factors in Morbidly Obese Adolescents

We examined the effect of laparoscopic adjustable gastric banding (LAGB) on weight loss, inflammatory markers, and components of the Metabolic Syndrome (MeS) in morbidly obese adolescents and determined if those with MeS lose less weight post-LAGB than those without. Data from 14-18 yr adolescents were obtained at baseline, 6 and 12 months following LAGB. Significant weight loss and improvements in MeS components were observed 6 months and one year following LAGB. The incidence of MeS declined 56.8% after 6 months and 69.6% after 12 months. There was no significant difference in amount of weight lost post-LAGB between those with and without MeS at either timepoint. Correlations between change in weight parameters and components of MeS in those with and without MeS at baseline were examined and found to vary by diagnostic category. LAGB is effective for short-term improvement in weight, inflammatory markers, and components of MeS in morbidly obese adolescents

Acute appendicitis following laparoscopic sleeve gastrectomy in an adolescent

Complications following laparoscopic sleeve gastrectomy may be life-threatening. The concern for serious complications may cause practitioners to overlook common surgical disease. The authors present a case of acute appendicitis that presented in the early post-operative period in an adolescent patient. Clinical suspicion and prompt imaging led to the correct diagnosis, timely management, and a favorable outcome

PERCUTANEOUS GASTROPEXY: A NOVEL APPROACH TO A FEARED COMPLICATION OF PERCUTANEOUS GASTROSTOMY TUBE PLACEMENT

Percutaneous endoscopic gastrostomy (PEG) tubes are commonly placed due to the ease and safety of the technique. Although uncommon, complications of this routine procedure can be catastraophic. A 13 month old former premature male developed peritonitis several hours after PEG placement. Following resuscitation, he was brought to the operating room where he was found to have diffuse peritonitis with ascites on initial laparoscopy. The PEG tube was in the stomach; we felt we could salvage the PEG by performing a gastropexy laparoscopically. In addition to the 5mm laparoscope port, two additional 4 mm ports were used to place 3 percutaneous sutures through the anterior abdominal wall. These were bolstered to the skin, and the patient did well post-operatively. The sutures were removed 15 days following the procedure. This video demonstrates a novel approach to addressing a complication of gastrostomy tube placemen

RE-EXPLORATION FOLLOWING LAPAROSCOPIC SLEEVE GASTRECTOMY

A 16 year old female with severe obesity underwent 6 months of multidisciplinary evaluation, after which she was offered laparoscopic sleeve gastrectomy. At surgery, peritoneal access was obtained using a 5mm non-cutting optical port. Sleeve gastrectomy was performed using a 40Fr bougie and multiple staple firings with bioabsorbable staple line reinforcement. On the second post-operative day she was noted to have a low grade fever and low urine output. Her physical exam was otherwise unremarkable and her wbc = 12,900. That evening a computed tomograph of the abdomen with oral contrast showed pneumoperitoneum, no extravisation of contrast from the gastric sleeve, and thickened bowel loops in the left upper abdomen. The following morning she complained of mild diffuse abdominal pain and return to the operating was carried out. At repeat laparoscopy she was found to have a through-and-through injury to the proximal small intestine. The bowel was repaired primarily