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New Treatments in Bariatric Surgery
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New Treatments in Bariatric Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "General Surgery".

Deadline for manuscript submissions: closed (25 August 2023) | Viewed by 6620

Special Issue Editor

Dr. Marius Nedelcu

E-Mail Website
Guest Editor
1. Department of General Surgery, Clinique Bouchard, ELSAN, 13006 Marseille, France
2. Department of General Surgery, Centre Chirurgical de l'Obesite, ELSAN, Clinique Saint Michel, Avenue de l'Orient, 83100 Toulon, France
Interests: bariatric surgery; metabolic surgery; gastroesophageal reflux disease
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Over the last decade, with the purpose of preventing the GERD, much interest has been paid to stomach sparing procedures, and several techniques have emerged with an important focus on bariatric endoscopy and various gastroplasty techniques. Less invasive endoscopic procedures are under development for the management of patients suffering from the morbid obesity disease. These new bariatric procedures should not be seen as a menace for traditional bariatric surgery, but, instead, they should be considered as a new addition to the treatment arsenal for obesity. Even if the initial results are encouraging, the durability and long-term results are highly debatable. Laparoscopic BariClip gastroplasty represents a non-resection procedure with more restriction than endoscopic procedures. Possessing the advantages of reversibility by clipping and not cutting the stomach, the BariClip procedure reproduces similar effects to a gastric sleeve.

Different new topics concerning the GERD (esophageal manometry), as well as new recommendations (e.g., pregnancy after bariatric surgery, the management of biliary lithiasis or systematic recoding), will be thoroughly discussed in the current Special Issue.

Dr. Marius Nedelcu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • bariatric surgery
  • endoscopic sleeve gastroplasty
  • BariClip
  • gastroesophageal reflux disease—GERD
  • SADI
  • radiological drainage

Published Papers (3 papers)

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Research

7 pages, 826 KiB  
Article
Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
by Marius Nedelcu, Thierry Manos, Patrick Noel, Marc Danan, Viola Zulian, Ramon Vilallonga, Anamaria Nedelcu and Sergio Carandina
J. Clin. Med. 2023, 12(4), 1376; https://doi.org/10.3390/jcm12041376 - 09 Feb 2023
Cited by 2 | Viewed by 1544
Abstract
Introduction: Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate the [...] Read more.
Introduction: Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate the need for surgical drainage for leak following LSG. Methods: All consecutive patients having gone through LSG from January 2017 to December 2020 were enrolled in our study. Once the demographic data and the leak history were registered, we analyzed the outcome of the surgical or endoscopic drainage, the characteristics of the endoscopic treatment, and the evolution to complete healing. Results: A total of 1249 patients underwent LSG and the leak occurred in 11 cases (0.9%). There were 10 women with a mean age of 47.8 years (27–63). The surgical drainage was performed for three patients and the rest of the eight patients underwent primary endoscopic treatment. The endoscopic treatment was represented with pigtails for seven cases and septotomy with balloon dilation for four cases. In two out of these four cases, the septotomy was anticipated by the use of a nasocavitary drain for 2 weeks. The average number of endoscopic procedures was 3.2 (range 2–6). The leaks achieved complete healing after an average duration of 4.8 months (range 1–9 months). No mortality was recorded for a leak. Conclusions: The treatment of the gastric leak must be tailored to each patient. Although there is still no consensus for the endoscopic drainage of leaks after LSG, the surgical approach can be avoided in up to 72%. The benefits of pigtails and nasocavitary drains followed by endoscopic septotomy are undeniable, and they should be included in the armamentarium of any bariatric center. Full article
(This article belongs to the Special Issue New Treatments in Bariatric Surgery)
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10 pages, 1109 KiB  
Article
Analysis of the Variability in Different Criteria to Define the Success of Bariatric Surgery: Retrospective Study 5-Year Follow-Up after Sleeve Gastrectomy and Roux-en-Y Gastric Bypass
by Sergi Sanchez-Cordero, Amador Garcia Ruiz de Gordejuela, Ramon Vilallonga, Oscar Gonzalez, Ana Ciscar, Andreea Ciudin, Alba Zabalegui and Manuel Armengol
J. Clin. Med. 2023, 12(1), 187; https://doi.org/10.3390/jcm12010187 - 26 Dec 2022
Cited by 4 | Viewed by 2131
Abstract
(1) Background: The current criteria for defining good or bad responders to bariatric surgery based on the percentage of weight loss do not properly reflect the therapeutic impact of the main bariatric techniques. At present there is an urgent need to fill this [...] Read more.
(1) Background: The current criteria for defining good or bad responders to bariatric surgery based on the percentage of weight loss do not properly reflect the therapeutic impact of the main bariatric techniques. At present there is an urgent need to fill this gap and provide scientific evidence that better define the success or failure of bariatric surgery in the long term. (2) Methods: This is a retrospective database study of a prospective cohort with 5-year follow-up. We established the success or failure of bariatric surgery in terms of weight loss according to a selected criterion: (1) Halverson and Koehler; (2) Reinhold modified by Christou; (3) Biron; (4) TWL > 20%; (5) percentage of changeable weight (AWL > 35%). We analyzed sensitivity and specificity for successful weight loss. (3) Results: 223 (38.7%) patients underwent sleeve gastrectomy (LSG) and 353 (61.2%) underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP). The success rates at 5 years are: EWL > 50% 464 (80%), Reinhold 436 (75.6%), Biron 530 (92%), TWL > 20% 493 (85.5%), AWL < 35% 419 (72.7); ≥50% EWL and alterable weight loss AWL > 35 were the most adequate criteria as their specificities and sensibility were far above >80%. (4) Conclusions: The present study shows how the different definitions of success or failure are inconsistent in relation to the outcomes of BS. However, there are some criteria that associate statistically significant differences for the resolution of comorbidities and show the highest sensitivity and specificity rates. Full article
(This article belongs to the Special Issue New Treatments in Bariatric Surgery)
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9 pages, 1383 KiB  
Article
One-Anastomosis Gastric Bypass and Hiatal Hernia: Nissen Fundoplication with the Excluded Stomach to Decrease the Risk of Postoperative Gastroesophageal Reflux
by Antoine Soprani, Hortense Boullenois, Viola Zulian, Anamaria Nedelcu and Sergio Carandina
J. Clin. Med. 2022, 11(21), 6441; https://doi.org/10.3390/jcm11216441 - 30 Oct 2022
Cited by 1 | Viewed by 2416
Abstract
Introduction: The realization of an antireflux valve according to the Nissen technique during the operation of one-anastomosis gastric bypass (OAGB) may theoretically decrease the incidence of postoperative reflux in patients with hiatal hernia (HH). Material and Methods: In this retrospective study, we included [...] Read more.
Introduction: The realization of an antireflux valve according to the Nissen technique during the operation of one-anastomosis gastric bypass (OAGB) may theoretically decrease the incidence of postoperative reflux in patients with hiatal hernia (HH). Material and Methods: In this retrospective study, we included all patients operated on between January 2015 and January 2019 for an OAGB associated with the creation of an antireflux Nissen valve (360-degree wrap). The patients included had type II or type III HH that had been diagnosed preoperatively or discovered intraoperatively. Results: Twenty-two patients were operated on during the period considered. The mean preoperative BMI was 40 ± 14 kg/m2. Five patients (22.7%) had a history of bariatric surgery. Typical symptoms of gastroesophageal reflux disease (GERD) were preoperatively present in four patients (18%), and HH was revealed preoperatively only in four patients; for all the other patients, the diagnosis of HH was made intraoperatively. The rate of early and/or late postoperative complications was 0%. The mean duration of follow-up was 23 ± 15 months. No dysphagia was reported during follow-up. Three patients presented with symptomatic GERD postoperatively, including one de novo. Mean BMI at the end of follow-up was 24 ± 3 kg/m2, and the % of total weight loss was 108 ± 30%. Conclusions: OAGB with a Nissen antireflux valve seems to be a safe and effective surgical technique and it could be an extra arrow in the surgeon’s quiver in the presence of HH in a patient scheduled for OAGB. Full article
(This article belongs to the Special Issue New Treatments in Bariatric Surgery)
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