Obesity surgery
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The intragastric balloon is filled with saline and methylene blue dye, to detect balloon deflation early and prevent bowel obstruction, by monitoring the patient's urine for changes in color. ⋯ Propofol, a sedative commonly used by anesthesiologists during endoscopic procedures, is known to have several side-effects, and urine discoloration is one of them, albeit rare. This benign side-effect must be known to obesity surgeons to avoid pointless medical expenditure, unnecessary balloon removal and distress for patients and clinicians.
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Randomized Controlled Trial Comparative Study Clinical Trial
Use of anti-emetics after intragastric balloon placement: experience with three different drug treatments.
Tropisetron treatment was compared with alizapride treatment. The secondary aim was to assess whether droperidol supplement would still improve the therapeutic outcome of tropisetron. ⋯ To decrease the incidence of vomiting in patients undergoing intragastric balloon placement, tropisetron proved to be the most effective antiemetic. A supplement of droperidol gave no better results but impaired postoperative mood and wellbeing. Alizapride was least effective.
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Surgical management of the supersuper obese patient (BMI >60 kg/m2) has been a challenging problem associated with higher morbidity, mortality, and long-term weight loss failure. Current limited experience exists with a two-stage biliopancreatic diversion and duodenal switch in the supersuper obese patient, and we now present our early experience with a two-stage gastric bypass for these patients. ⋯ Laparoscopic sleeve gastrectomy with second-stage Roux-en-Y gastric bypass are feasible and effective procedures based on short-term results. This two-stage approach is a reasonable alternative for surgical treatment of the high-risk supersuper obese patient.