By Mervyn Deitel (auth.), Michael Korenkov (eds.)
The expanding occurrence of weight problems in lots of international locations signifies that it's going to now be thought of an epidemic. it really is well known that weight problems raises the danger of numerous life-threatening stipulations, together with middle affliction, diabetes, and high blood pressure. Bariatric surgical procedure is usually the simplest method to deal with such morbid weight problems. however, whereas numerous bariatric strategies were proposed, thus far criteria were missing. during this publication, major specialists from around the globe speak about all facets of bariatric surgical procedure and current their very own preferred types of surgeries through informative illustrations. Technical nuances are rigorously defined, and specified awareness is dedicated to power issues and the way to prevent them. The services of the authors and the variety of recommendations thought of be sure that either trainees in bariatric surgical procedure and skilled surgeons will locate this e-book to be a useful resource of data and counsel of their day-by-day work.
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Extra resources for Bariatric Surgery: Technical Variations and Complications
The slight diffuse hemorrhage that may occur during blunt dissection stops spontaneously. A coagulation hook is very rarely ever needed. • After reaching the fat tissue on the opposite side, insert a flexible dissector or a “goldfinger” into the retrogastric tunnel. Dissect the tip of the instrument in the angle of His. • Continue as above (pars-flaccida pathway). Hemorrhage Hemorrhage occurs mostly through an injury of the left hepatic lobe with the liver retractor. Patients with a massive fatty liver (BMI over 50, long standing morbid obesity) are especially at risk.
The aim is to limit the size of the stomach to a small pouch, which is created by tightening the gastric band (Figs. 2). At first the idea of restricting the size of the stomach was carried out by performing gastroplasty. This procedure however was irreversible and the laparoscopic procedure faced major technical difficulties. Also the band was not adjustable, which is why this procedure is hardly performed anymore and has been replaced by adjustable gastric banding. M. A. I. Smith Australian Centre for Obesity Research and Education.
Instead, we use a large drape over each leg and then a drape across the pelvic region. Wendy A. Brown and Andrew I. Smith Preparation Setting, Positioning, and the Surgical Team • The patient is positioned in the lithotomy position. We use a table with either a buttock support or an adjustable seat as the patient will ultimately be tilted head-up to around 45°. • The legs are supported in stirrups with the knees angled toward the opposite shoulder. The legs must be kept relatively low so that when the operator is between the legs their arms and instruments do not clash with the legs.