... mail: juliana_gamba@yahoo.com.br Morphological analysis of the ostrich eggshell is important ... more ... mail: juliana_gamba@yahoo.com.br Morphological analysis of the ostrich eggshell is important because several factors can be related ... provavelmente em grande parte do albúmen), morte em-brionária e, portanto, na eclodibilidade (Nahm 2001, Sahan et al. ... 1999, Hassan et al ...
Page 1. Pesq. agropec. bras., Brasília, v. 37, n. 9, p. 1205-1212, set. 2002 1205 Incidência de a... more Page 1. Pesq. agropec. bras., Brasília, v. 37, n. 9, p. 1205-1212, set. 2002 1205 Incidência de ascite em frangos de corte Incidência de ascite em frangos de corte alimentados com rações comerciais de alto nível energético(1) ...
Laparoscopic sleeve gastrectomy is gaining popularity as a treatment of morbid obesity. It is a r... more Laparoscopic sleeve gastrectomy is gaining popularity as a treatment of morbid obesity. It is a relatively new procedure with a postoperative follow-up not exceeding 5 years. The natural orifice transluminal endoscopic surgical procedures are also gaining in popularity, and we are now experiencing the first transition from animal to human trials. We describe the first sleeve gastrectomy surgery for morbid obesity using the vagina as the natural orifice in the form of a hybrid natural orifice transluminal endoscopic surgery transvaginal sleeve gastrectomy, including the short-term outcomes and complications.
Migration of the adjustable gastric band (AGB) is a serious complication which usually does not r... more Migration of the adjustable gastric band (AGB) is a serious complication which usually does not require emergency treatment, except when there is a risk to life.We report a 30-year-old patient who presented with syncope, melena and hypovolemic shock due to the intragastric erosion of an AGB, 13 months after laparoscopic band placement. The diagnosis of migration had been made 7 months after placement, and bleeding only occurred 6 months later. Greater intraluminal penetration had been awaited to facilitate gastroscopic extraction, but, faced with hemodynamic instability, resuscitation was carried out followed by emergency endoscopy to cut the device, using endoscopic scissors. Then, the band was removed orally. There has been no recurrence of hemorrhage 12 months later. Delayed treatment may be indicated in cases of initial band migration; however, rigorous follow-up is necessary with frequent re-evaluation, to diagnose potentially life-threatening complications promptly.
Background Vertical sleeve gastrectomy (VSG) is a surgical technique that involves resection of a... more Background Vertical sleeve gastrectomy (VSG) is a surgical technique that involves resection of a significant portion of the stomach. This surgery is sometimes associated with gastric leaks, which can be difficult to treat. The present study reports findings from laparoscopic greater curvature plication (LGCP), which is an alternative bariatric procedure similar to VSG but without the need for gastric resection. Methods A prospective study was carried out, following LGCP in 42 morbidly obese patients (30 female/12 male) with a mean age of 33.5 years (23 to 48) and mean BMI of 41 kg/m² (35 to 46). Through a five-port approach, the stomach was reduced by dissecting the greater omentum and short gastric vessels, as in VSG, and the greater curvature was then invaginated using multiple rows of non-absorbable suture performed over a 32-Fr bougie to ensure a patent lumen. Results All procedures were completed laparoscopically. Mean operative time was 50 min (40 to 100 min) and mean hospital stay was 36 h (24 to 96). Patients returned to their regular activities at an average of 7 days (4 to 13) following surgery. No intra-operative complications occurred. All patients experienced excess weight loss (EWL) of at least 20% after 1 month. Mean EWL was 62% (45% to 77%) in nine patients after 18 months. There has been no record of weight regain in any patient to date. Conclusions LGCP is feasible, safe, and effective for at least 18 months when performed on morbidly obese patients. Longer follow-up and prospective comparative trials are needed.
One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, lead... more One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de São Paulo, São Paulo, and Universidade Federal de Pernambuco, Recife, Brazil.From 2003 to 2008, 82 patients were diagnosed with band erosion. The clinical data concerning the endoscopic procedure were prospectively recorded and retrospectively reviewed.The average preoperative body mass index was 43.2 kg/m2 (range 34–50). At the diagnosis of intragastric erosion, the body mass index was 24–41 kg/m2 (average 31.8). The erosion occurred an average of 16.3 months (range 6–36) postoperatively. The symptoms included pain in 25 (31%), port infection in 21 patients (27%), and weight regain in 20 (25%), and 12 patients (15%) were asymptomatic. Endoscopic removal was possible for 78 patients (95%). In 85% of patients, the band was removed in the first session, with an average duration of 55 minutes (range 25–150). Five cases of pneumoperitoneum occurred after the procedure. Of these, 3 were treated conservatively, 1 was treated by laparoscopy, and 1 was treated by abdominal puncture using the Veress needle.Endoscopic removal of eroded laparoscopic adjustable gastric banding is safe and effective. It can be used as a first choice procedure in clinical practice.
Background The association between medical and dietetic–behavioral treatments of type 2 diabetes ... more Background The association between medical and dietetic–behavioral treatments of type 2 diabetes mellitus (T2DM) has demonstrated to have variable results. The surgical treatment of T2DM is justifiable after the observation of a successful glycemic control in patients submitted to Roux-en-Y gastric bypass and biliopancreatic diversion. Experiments have shown an important role of the proximal intestine in glycemia decrease and diabetes control. Methods Twenty diabetic patients underwent laparoscopic duodenal–jejunal exclusion. The variables studied were body mass index (BMI), fasting glycemia, glycosylated hemoglobin (HbA1c), and C-peptide, in the preoperative period and after 3 and 6 months. Results There was a BMI decrease up to the third month and a weight stabilization between the third and sixth months. There was a significant reduction in fasting glycemia (43.8%) and HbA1c (22.8%) up to the sixth month (p p Conclusions Preliminary results have shown an important effect of the laparoscopic duodenal–jejunal exclusion in the treatment of T2DM. Studies with longer follow-up and a larger number of patients are necessary to better define the role of this new and promising procedure.
... mail: juliana_gamba@yahoo.com.br Morphological analysis of the ostrich eggshell is important ... more ... mail: juliana_gamba@yahoo.com.br Morphological analysis of the ostrich eggshell is important because several factors can be related ... provavelmente em grande parte do albúmen), morte em-brionária e, portanto, na eclodibilidade (Nahm 2001, Sahan et al. ... 1999, Hassan et al ...
Page 1. Pesq. agropec. bras., Brasília, v. 37, n. 9, p. 1205-1212, set. 2002 1205 Incidência de a... more Page 1. Pesq. agropec. bras., Brasília, v. 37, n. 9, p. 1205-1212, set. 2002 1205 Incidência de ascite em frangos de corte Incidência de ascite em frangos de corte alimentados com rações comerciais de alto nível energético(1) ...
Laparoscopic sleeve gastrectomy is gaining popularity as a treatment of morbid obesity. It is a r... more Laparoscopic sleeve gastrectomy is gaining popularity as a treatment of morbid obesity. It is a relatively new procedure with a postoperative follow-up not exceeding 5 years. The natural orifice transluminal endoscopic surgical procedures are also gaining in popularity, and we are now experiencing the first transition from animal to human trials. We describe the first sleeve gastrectomy surgery for morbid obesity using the vagina as the natural orifice in the form of a hybrid natural orifice transluminal endoscopic surgery transvaginal sleeve gastrectomy, including the short-term outcomes and complications.
Migration of the adjustable gastric band (AGB) is a serious complication which usually does not r... more Migration of the adjustable gastric band (AGB) is a serious complication which usually does not require emergency treatment, except when there is a risk to life.We report a 30-year-old patient who presented with syncope, melena and hypovolemic shock due to the intragastric erosion of an AGB, 13 months after laparoscopic band placement. The diagnosis of migration had been made 7 months after placement, and bleeding only occurred 6 months later. Greater intraluminal penetration had been awaited to facilitate gastroscopic extraction, but, faced with hemodynamic instability, resuscitation was carried out followed by emergency endoscopy to cut the device, using endoscopic scissors. Then, the band was removed orally. There has been no recurrence of hemorrhage 12 months later. Delayed treatment may be indicated in cases of initial band migration; however, rigorous follow-up is necessary with frequent re-evaluation, to diagnose potentially life-threatening complications promptly.
Background Vertical sleeve gastrectomy (VSG) is a surgical technique that involves resection of a... more Background Vertical sleeve gastrectomy (VSG) is a surgical technique that involves resection of a significant portion of the stomach. This surgery is sometimes associated with gastric leaks, which can be difficult to treat. The present study reports findings from laparoscopic greater curvature plication (LGCP), which is an alternative bariatric procedure similar to VSG but without the need for gastric resection. Methods A prospective study was carried out, following LGCP in 42 morbidly obese patients (30 female/12 male) with a mean age of 33.5 years (23 to 48) and mean BMI of 41 kg/m² (35 to 46). Through a five-port approach, the stomach was reduced by dissecting the greater omentum and short gastric vessels, as in VSG, and the greater curvature was then invaginated using multiple rows of non-absorbable suture performed over a 32-Fr bougie to ensure a patent lumen. Results All procedures were completed laparoscopically. Mean operative time was 50 min (40 to 100 min) and mean hospital stay was 36 h (24 to 96). Patients returned to their regular activities at an average of 7 days (4 to 13) following surgery. No intra-operative complications occurred. All patients experienced excess weight loss (EWL) of at least 20% after 1 month. Mean EWL was 62% (45% to 77%) in nine patients after 18 months. There has been no record of weight regain in any patient to date. Conclusions LGCP is feasible, safe, and effective for at least 18 months when performed on morbidly obese patients. Longer follow-up and prospective comparative trials are needed.
One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, lead... more One of the complications of laparoscopic adjustable gastric banding is intragastric erosion, leading to a revisional procedure to remove the band. Our aim was to present the procedure and results of endoscopic band removal in a 5-year multicenter experience from the Gastro Obeso Center and Universidade de São Paulo, São Paulo, and Universidade Federal de Pernambuco, Recife, Brazil.From 2003 to 2008, 82 patients were diagnosed with band erosion. The clinical data concerning the endoscopic procedure were prospectively recorded and retrospectively reviewed.The average preoperative body mass index was 43.2 kg/m2 (range 34–50). At the diagnosis of intragastric erosion, the body mass index was 24–41 kg/m2 (average 31.8). The erosion occurred an average of 16.3 months (range 6–36) postoperatively. The symptoms included pain in 25 (31%), port infection in 21 patients (27%), and weight regain in 20 (25%), and 12 patients (15%) were asymptomatic. Endoscopic removal was possible for 78 patients (95%). In 85% of patients, the band was removed in the first session, with an average duration of 55 minutes (range 25–150). Five cases of pneumoperitoneum occurred after the procedure. Of these, 3 were treated conservatively, 1 was treated by laparoscopy, and 1 was treated by abdominal puncture using the Veress needle.Endoscopic removal of eroded laparoscopic adjustable gastric banding is safe and effective. It can be used as a first choice procedure in clinical practice.
Background The association between medical and dietetic–behavioral treatments of type 2 diabetes ... more Background The association between medical and dietetic–behavioral treatments of type 2 diabetes mellitus (T2DM) has demonstrated to have variable results. The surgical treatment of T2DM is justifiable after the observation of a successful glycemic control in patients submitted to Roux-en-Y gastric bypass and biliopancreatic diversion. Experiments have shown an important role of the proximal intestine in glycemia decrease and diabetes control. Methods Twenty diabetic patients underwent laparoscopic duodenal–jejunal exclusion. The variables studied were body mass index (BMI), fasting glycemia, glycosylated hemoglobin (HbA1c), and C-peptide, in the preoperative period and after 3 and 6 months. Results There was a BMI decrease up to the third month and a weight stabilization between the third and sixth months. There was a significant reduction in fasting glycemia (43.8%) and HbA1c (22.8%) up to the sixth month (p p Conclusions Preliminary results have shown an important effect of the laparoscopic duodenal–jejunal exclusion in the treatment of T2DM. Studies with longer follow-up and a larger number of patients are necessary to better define the role of this new and promising procedure.
Uploads
Papers by Manoel Neto