March 6th, 2010 by Fred Lotgering
The number of weight-loss operations in USA soared 800 percent between 1998 and 2004, and another 11 percent between 2005 and 2006. Americans get more than 205,000 obesity surgeries a year, according to the American Society for Metabolic and Bariatric Surgery – a number that is almost certain to keep climbing.
Type 2 diabetes affects an estimated 21 million Americans and 200 million people worldwide. According to the World Health Organization, type 2 diabetes comprises 90% of people with diabetes around the world, and is largely the result of excess body weight. Type 2 diabetes can lead to significant health problems including cardiovascular disease, retinopathy, neuropathy and nephropathy.
Diabetes is the fifth-leading cause of death in the United States. The death toll from diabetes has grown by nearly 50 percent in the past 20 years.
Obesity surgery leads to substantial and durable weight reduction. Nearly 30% of patients who undergo obesity surgery have type 2 diabetes, and for many of them, diabetes resolves after surgery (84% to 98% for bypass procedures and 48% to 68% for restrictive procedures, such as lapbands). Another new obesity surgery, the EndoBarrier Gastrointestinal Liner also demonstrated diabetes improvement.
[tags]new obesity surgery, diabetes type 2, EndoBarrier Gastrointestinal Liner[/tags]
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March 6th, 2010 by Fred Lotgering
Robotics is a cutting-edge method of performing surgery using only a few small incisions, or keyholes similar to that used in laparoscopic cases, as ports for instruments that allow access to the heart, lungs and abdomen, while at the same time fine-tuning the technical skills of the surgeon. This surgery is performed in a three dimensional image compared to the two dimensions of laparoscopic surgery. Robotic instrumentation works by mimicking the motions and movements of the surgeons’ hands and fingers. This provides an added element of dexterity for the surgeon. Furthermore, the da Vinci’s wrist action capabilities allow the surgeon to get around corners and in tight spaces for improved precision.
Robotics surgery is a particularly good option for bariatric patients who choose the gastric bypass procedure.
When performing a gastric bypass procedure, the most complicated and important part of the surgery is creating the communication between the stomach and small bowel after creating the gastric pouch. The most common approaches in connecting them are to either staple or to hand sew them together, but the best results to date and the least complications have been demonstrated with the sewing approach. The robot makes hand sewing much easier by increasing the dexterity, precision and vision of the surgeon in the tight space. More and more studies are now showing that not only in bariatrics but also in other surgical specialties complication rates are less in the robotic assisted approach when compared to the standard laparoscopic approaches.
[tags]robotics surgery, robotic obesity surgery, new obesity surgery techniques, laparoscopic surgery[/tags]
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March 6th, 2010 by Fred Lotgering
New information from weight loss researchers and nutritionists shows that over 300,000 people die each year from complications resulting from obesity. Obesity is a major problem in the United States and now many other parts of the world. This is where the body accumulates more fat than is being burned by normal metabolism and this causes fat deposits to begin to build up in the belly area, thighs, buttocks and even waist. The problem of obesity is so acute that some schools especially in Atlanta Georgia have began to offer strictly vegetarian diets to their students and the students have embraced this diet well. So what causes obesity?
There is one cause of weight gain that is rather unfortunate-genetics. Sometimes, it is easy to judge people from appearance and form an opinion that their excess weight is as a result of irresponsible eating habits. But doctors report that there are people with genetic maladjustments that cause a problem with the way the body processes food. There are also problems that cause an under-performing thyroid gland that ultimately causes the body metabolism to slow and therefore and accumulation of fat. So one reason why some people are overweight is because of genetic issues.
Another reason why some people might have a weight problem is because they have an eating disorder. In the same token that there are eating disorders which cause bulimia, there are disorders that run in the opposite direction and cause compulsive eating and an abnormal appetitive. A disorder called Pica even has its victims craving non-foods (earth, pens, pencils and anything close by). These disorders which cause excessive eating can be treated and the person can resume normal eating habits.
Another reason for obesity is off course leading a sedentary life of little or no activity. This is common in the West where people use cars to go even short distances.
[tags]obesity causes,obesity,problem of obesity, reasons for obesity[/tags]
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March 2nd, 2010 by Fred Lotgering
The history of obesity can be traced back for many years.
Obesity surgery (or Bariatric surgery, bariatric is from the Greek for “weight” and “treatment”) has continually evolved since its initial sporadic and tentative introduction in the 1950’s. Many innovations and improvements have been made since to make the procedure safer.
1954.
The first reported event of gastric bypass surgery was in 1954. Dr. A.J. Kremen and his team connected the patient’s upper and lower intestine, which bypassed much of the absorption area. The case which they presented was of a jejuno-ileal bypass.(JIB).As a consequence of manycomplications, the jejuno-ileal bypass is no longer a recommended Obesity Surgical Procedure.
JIB is the classic example of a malabsoptive weight loss procedure. There are some modern malabsoptive procedures utilize a lesser degree of malabsorption combined with gastric restriction to induce and maintain weight loss.
1963
Obesity surgery continued its evolution in 1963 with gastric bypass techniques applied by Drs. Payne, DeWind and Commons. Their procedure consisted of what is known as a jejunocolic shunt. The jeujuno-ileal bypass connected the upper small intestine to the colon. This technique resulted in uncontrollable diarrhea in the patients.
1967.
Gastric bypass was developed in 1966, by Dr. Edward E. Mason of the University of Iowa. He used surgical staples to create a partition across the upper stomach. This partition reduces the intake of food. The pouch that is created gives patients a feeling of fullness, even when they eat a small amount of food. The procedure was called vertical banded gastroplasty (also called mini gastric bypass)
1988
In 1988 Hess, started developing a hybrid operation with the advantages of the BPD but without some of the associated problems.and consisted of a suprapapillary Roux-en-Y duodeno-jejunostomy.
1990
In 1990 there was the gastric band by Drs. Kuzmac and Yap.
1993
In 1993 was the duodenal switch from Drs. Hess and Marceau, which ended stomach ulcers with the procedure. This technique, was first presented by Hess in 1992 and first published in a paper by Marceau, Biron et al in 1993 is known as Biliopancreatic Diversion with Duodenal Switch (BPDDS). This procedure is claimed to essentially eliminate stomal ulcer and dumping syndrome. BPD and its variants became one of the major procedures performed for obesity in that time.
1994
In 1994 Wittgrove e Clark performed the first Laparoscopic Gastric Bypass. An increasing number of surgeons , expert at endoscopic/laparoscopic surgery, are today performing Gastric Bypass Surgry using laparoscopic techniques.
1996
The Roux-en-Y gastric bypass procedure was developed by Professor Nicola Scopinaro, of the University of Genoa, Italy.(Scopinaro, Gianetta et al. 1996). This is the procedure still used in surgeries today. The Roux en-Y gastric bypass, loops from the upper stomach to the small bowel. This type of surgery has the most effective weight loss which creates the least in nutritional deficiencies and is now the commonly used obesity surgery.
This procedure has two components. A limited gastrectomy results in reduction of oral intake, inducing weight loss, especially during the first postoperative year. The second component of the operation, construction of a long limb Roux-en-Y anastomosis with a short common “alimentary” channel of 50 cms length. This creates a significant malabsorptive component which acts to maintain weight loss long term.
Dr Scopinaro published long term results of this operation, reporting 72% excess body weight loss maintained for 18 years. These are excelent results, in terms of weight loss and duration of weight loss and reported in the bariatric surgical literature.
2000 and beyond
The lapararoscopic Roux-enY Gastric Bypass is now the most common obesity surgery. New Obesity Surgery techniques are being developed and clinical tested.. This blog will report extensively on these new developments.
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February 6th, 2010 by Fred Lotgering
Welcome to the “new”: New Obesity Surgery Blog
Stay alert, posts will appear soon….!
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