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JournalISSN: 0930-2794

Surgical Endoscopy and Other Interventional Techniques 

Springer Science+Business Media
About: Surgical Endoscopy and Other Interventional Techniques is an academic journal published by Springer Science+Business Media. The journal publishes majorly in the area(s): Abdominal surgery & Laparoscopic surgery. It has an ISSN identifier of 0930-2794. Over the lifetime, 15763 publications have been published receiving 505966 citations. The journal is also known as: Surgical endoscopy (Internet) & Surgical endoscopy (2002. Print).


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Journal ArticleDOI
TL;DR: Peroral endoscopic suturing to tighten dilated gastrojejunal anastomoses appears technically feasible and safe, and preliminary results suggest that it may offer a new treatment option for postbypass weight regain in selected patients.
Abstract: Roux-en-Y gastric bypass (RYGB) is an effective treatment for severe obesity. However, many patients regain weight over time. The mechanisms for this are unclear, and several factors may contribute, including dilation of the gastrojejunal anastomosis. This study aimed to assess the feasibility of endoscopic gastrojejunal anastomotic tightening and to determine the effect of tightening on body weight. Eight patients with significant weight regain and dilated gastrojejunal anastomosis after RYGB were included in this pilot study. Sutures were placed endoscopically at the rim of the anastomosis. When tightened, the sutures formed tissue placations, reducing the size of the anastomotic aperture. The average preprocedure body mass index (BMI) was 40.5, and the patients had regained a mean of 24 kg from their post-RYGB nadir. The average pouch length was 5.7 cm, and the average anastomotic diameter was 25 mm. The average postreduction diameter was 10.0 mm (68% reduction). Six of the eight patients showed weight loss (mean, 10 kg) at 4 months. Repeat procedures were performed for three patients who had lost 4, 5, and 9 kg, respectively with the initial procedure. After the second anastomotic reduction, the final diameters were, respectively, 14, 5, and 5 mm. The first patient did not have further weight loss. The remaining two patients showed a total weight loss of 19 and 20 kg, respectively, at 5 months. All 11 reductions were accomplished without significant complication. The average postreduction BMI was 37.7, and the percentage of excess weight loss was 23.4%. Peroral endoscopic suturing to tighten dilated gastrojejunal anastomoses appears technically feasible and safe. This procedure is associated with variable but significant weight loss, and preliminary results suggest that it may offer a new treatment option for postbypass weight regain in selected patients.

949 citations

Journal ArticleDOI
TL;DR: The group identified the barriers that needed to be surmounted for the development of translumenal endoscopic intraperitoneal surgery and developed a list of next steps and guidelines to move this concept ahead.
Abstract: The growing capabilities of therapeutic flexible endoscopy have ushered in a new era in the treatment of gastrointestinal conditions. Refinements in laparoscopic surgery have progressed to the point that complex surgical procedures, such as gastric bypass, can now be performed in a minimally invasive fashion. These trends have set the stage for the development of even less invasive methods to treat conditions in both the gut lumen and in the peritoneal cavity. It seems feasible that major intraperitoneal surgery may one day be performed without skin incisions. The natural orifices may provide the entry point for surgical interventions in the peritoneal cavity, thereby avoiding abdominal wall incisions. In the first published description, Kalloo et al. [1] demonstrated the feasibility and safety of a per-oral transgastric endoscopic approach to the peritoneal cavity with long-term survival in a porcine model. This was soon followed by other transgastric peritoneal procedures in the porcine model, including tubal ligation, [2] cholecystectomy, [3] gastrojejunostomy, [4] splenectomy, [5] and oophorectomy with tubectomy [6, 7]. Although there are no publications, Rao et al. have described transgastric appendectomy in humans (personal communication). There have been two excellent editorials on this potentially emerging field. [8, 9] To discuss this vision, 14 leaders from the American Society of Gastrointestinal Endoscopy (ASGE) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) met in New York City on July 22 and 23, 2005. The participants are listed in Table 1. All agreed that Translumenal Endoscopic Surgery could offer significant benefits to patients such as less pain, faster recovery, and better cosmesis than current laparoscopic techniques. The group identified the barriers that needed to be surmounted for the development of translumenal endoscopic intraperitoneal surgery and developed a list of next steps and guidelines to move this concept ahead.

857 citations

Journal ArticleDOI
TL;DR: Although technically feasible, the laparoscopic Whipple procedure may not improve the postoperatively outcome or shorten the postoperative recovery period.
Abstract: A case of chronic pancreatitis localized in the head of the pancreas with pancreas divisum was treated by laparoscopic pylorus-preserving pancreatoduodenectomy. The laparoscopic technique of resection and reconstruction with a gastrojejunostomy, hepaticojejunostomy, and pancreaticojejunostomy is described. The postoperative period was complicated by a jejunal ulcer and delayed gastric emptying necessitating a prolonged hospitalization and intravenous hyperalimentation. No fistulas occurred, a follow-up CT scan revealed no pancreatic abnormalities, and the patient was discharged in good condition on the 30th postoperative day. Although technically feasible, the laparoscopic Whipple procedure may not improve the postoperative outcome or shorten the postoperative recovery period.

779 citations

Journal ArticleDOI
TL;DR: A means of performing a cholecystectomy through a laparoscope using laser technology is developed, the results of which are compared here with the results in a series of “mini-lap” choleCystectomies that were performed during the same time period.
Abstract: The standard treatment of cholelithiasis in the United States is surgical removal of the gallbladder, but this treatment often has a major economic impact on the patient: major surgery, lengthy hospitalization, and several weeks' absence from work. Because of this economic factor, there has been a movement toward non-invasive methods, but they, too, have their drawbacks: long-term medical therapy; a high risk of stone recurrence because the diseased gallbladder is still in place. We therefore developed a means of performing a cholecystectomy through a laparoscope using laser technology, the results of which are compared here with the results in a series of "mini-lap" cholecystectomies that we also performed during the same time period.

739 citations

Journal ArticleDOI
TL;DR: In this paper, the authors compared the bursting strength of three hundred thirty-one arteries and veins sealed by application of precisely controlled electrothermal energy and physical pressure, allowing for brief cooling in compression, in experimental animals and fresh abattoir vessels.
Abstract: Background: The inherent tedium of intracorporeal knot tying has stimulated greater interest in energy-based and mechanical alternatives for hemostasis. Methods: Three hundred thirty-one arteries and veins were sealed by application of precisely controlled electrothermal energy and physical pressure, allowing for brief cooling in compression, in experimental animals and fresh abattoir vessels. These seals were compared for bursting strength with occlusions by ultrasonic and bipolar coagulation, surgical clips, and ligatures. Results: Ultrasonic and bipolar occlusions were significantly less likely to have burst strengths greater than 400 mmHg as compared with seals, clips, and ligatures (p < 0.001). Seal competence could be visually assessed by its translucence. Conclusions: Precise energy control with physical compression, including a brief cooldown, produces a distinctive, translucent seal of partially denatured protein that can typically be transected after a single application. These seals have bursting strengths comparable to those of clips and ligatures and resist dislodgement because they are intrinsic to the vessel wall structure.

721 citations

Performance
Metrics
No. of papers from the Journal in previous years
YearPapers
2023435
2022910
20211,353
2020657
2019479
2018616