POSTER ABSTRACTS <strong>SAGES</strong> <strong>2005</strong> plantation. Parameters before and after transplant are expressed as group median values +- 1st and 3rd quartile deviations. RESULTS: To date, 4 dogs have been studied. All animals tolerated the surgery (100% survival 9 months post-transplant.) They maintained their body weight after transplant and there were no pre/post differences in activity level. All four parameters that make up the 24-h pH monitoring increased after transplant: total number of reflux episodes were 7 (5,13) before versus 12 (4,28) after; the number of reflux episodes longer that 5 min were 0 (0,1) before versus 1 (0,3) after; the longest reflux episode was 3.5 (1.8,8.0) min before versus 8.0 (1.0,20.0) min after; and the total time esophageal pH
POSTER ABSTRACTS P225–Complications of Surgery PITFALLS AND COMPLICATIONS OF LAPAROSCOPIC NISSEN FUNDOPLICATION, Mohey El-Banna, Mahmoud El- Meteini,Osama Fouad, Department of General Surgery, Ain Shams University Background: Since the introduction of laparoscopic Nissen fundoplication by Dallmagne 1991, its importance increased dramatically. In this study, the lessons learned from 60 consecutive laparoscopic Antireflux procedures (LAP) procedures are analyzed. Methods: Between March 2001 and March 2004, 60 cases were subjected to LAP for gastroesophageal reflux disease (GERD). The preoperative decision depended on Esophagogastroduodenoscopy (EGD) and Esophageal Manometry (EM) to record the lower esophageal sphincter pressure and length and the esophageal body motility pattern. Barium study was done for hiatus hernia. The operative details were recorded, as well as the postoperative outcome and complications. The postoperative study included a standardized questionnaire, EGD and EM. Results: Of the sixty cases studied, 6 cases were converted to open fundoplication due to gastric perforation, equipment failure and procedural difficulties. Four patients underwent Laparoscopic Toupet Fundoplication (LTF). Except three patients, all demonstrated subjective and objective improvement or cure of GERD. Conclusion: We concluded that LAP is a safe and effective approach for the management of GERD. However, the success of LAP depends on the ability of the surgeon to take into consideration the possible intra-operative complications and factors contributing to dissatisfaction with the functional outcome. P226–Complications of Surgery BLADELESS TROCAR HERNIA RATE IN UNCLOSED FASCIAL DEFECTS IN BARIATRIC PATIENTS, Alison M Fecher MD, Ross L McMahon MD,John P Grant MD,Aurora D Pryor MD, Duke University Medical Center Objective Utilization of the bladeless step trocar system has the perceived advantage of minimal trocar related hernias in patients undergoing laparoscopic Roux en Y Gastric Bypass surgery (RYGB). We propose a retrospective review of hernias in these patients and a review of the literature. Methods & Procedures A retrospective chart review was performed on 591 patients who underwent RYGB at Duke University Weight Loss Surgery Center from July 2002 through June 2004. A total of 2955 bladeless trocar sites were used. Step trocars were used in all cases. The configuration of ports included one Hasson port, two 12-mm and three 5-mm ports . The Hasson port was closed with a figure of eight number 1 Polysorb. All other trocar sites did not have fascial closure. The gastrojejunal anastomosis was created with a linear stapler in all of the laparoscopic cases with hand suturing of the residual enterotomy. The charts were reviewed for fascial defect, subsequent surgeries and intra-operative findings. Results There were no hernias seen at any of the unclosed bladeless trocar sites for a 0% incidence. There were four ventral hernias at the Hasson port site which required re-operation for repair for a 0.68% incidence. Conclusion There were no hernias from the unclosed bladeless trocar site with radial expanders out of a total of 1182 12-mm ports. Four hernias occurred at the Hasson port site. In the bariatric RYGB population the routine closure of radially expanding step trocars does not appear to be necessary due to the extremely low rate of subsequent hernia. P227–Complications of Surgery DELAYED PRESENTATION OF SPLENIC RUPTURE AFTER COLONOSCOPY, Richard Fortunato DO, Daniel Gagné MD,Pavlos Papasavas MD,Philip Caushaj MD, The Western Pennsylvania Hospital, Temple University Medical School Clinical Campus Splenic rupture after a colonoscopy is a rare but potentially fatal complication. Patients typically present with signs of abdominal pain and hemorrhagic shock within minutes to days after the procedure. We present a case of a 59 year-old woman with a past history of Hodgkin?s disease and gastric bypass who developed increasing abdominal pain three weeks after a routine colonoscopy and polypectomy. The patient presented with hypotension and underwent aggressive resuscitation with IVF and IV pressors. CT scan demonstrated a large subcapsular hematoma of the spleen. Angiography did not reveal active bleeding. Due to the patient?s continued clinical deterioration, she was taken emergently to the operating room for an exploratory laparotomy, which demonstrated a full splenic capsular avulsion and hemorrhage. The patient underwent splenectomy and had an uneventful recovery. Though usually presenting hours to a few days after colonoscopy, severe splenic injury can have an insidious onset weeks from the original insult. This is the most delayed presentation of such an injury after colonoscopy to date. P228–Complications of Surgery INCIDENCE OF INTERNAL HERNIA FOLLOWING LAPARO- SCOPIC RETROCOLIC RETROGASTRIC ROUX-EN-Y GASTRIC BYPASS, Giselle G Hamad MD, Gina M Kozak, PA-C, University of Pittsburgh The optimal route of the Roux limb in the laparoscopic Rouxen-Y gastric bypass remains controversial. The retrogastricretrocolic approach to Roux-en-Y gastric bypass has been criticized for the incidence of internal hernias at Petersen?s defect and the transverse mesocolon window. The postoperative weight loss coupled with the reduction in postoperative adhesions associated with the laparoscopic approach may contribute to a higher incidence of internal hernias. Internal herniation may lead to a closed loop obstruction and necessitates early surgical intervention. The purpose of this study was to determine the incidence of internal hernias among patients who underwent a retrocolic-retrogastric Roux-en-Y gastric bypass. Between 2001 and 2004, 520 patients underwent a retrocolic-retrogastric Roux-en-Y gastric bypass with continuous sutured closure of Petersen?s, transmesenteric, and small bowel mesenteric defects. Three patients were converted to open procedure (0.6%). There were 500 females and 20 males. Mean age was 40 years (range 18-65) and mean preoperative body mass index was 46.4 kg/m2 (range 36-68). Mean followup for all patients was 11 months and mean excess weight loss at 18 months was 70%. One patient (0.19%) who had lost 57% of excess weight three months after laparoscopic gastric bypass developed a high-grade small bowel obstruction and was diagnosed with an internal hernia by CT scan. An exploratory laparotomy was performed for reduction and repair of Petersen?s defect and the patient recovered uneventfully. Internal herniation is an infrequent complication following retrocolic-retrogastric laparoscopic Roux-en-Y gastric bypass. Meticulous continuous suture closure of the potential hernia defects is essential to reduce the incidence of this dreaded complication. P229–Complications of Surgery INCIDENCE OF STOMAL STENOSIS FOLLOWING LAPARO- SCOPIC RETROCOLIC-RETROGASTRIC ROUX-EN-Y GASTRIC BYPASS, Giselle G Hamad MD, Gina M Kozak PA-C, University of Pittsburgh Stomal stenosis is a complication reported in 3 to 37% of patients following Roux-en-Y gastric bypass. Contributing factors include tension of the Roux limb, ischemia, preserved acid secretion in the gastric pouch, NSAID use, and smoking. The optimal route of the Roux limb in the laparoscopic Roux-en-Y gastric bypass remains controversial. The retrocolic-retrogastric route has been said to subject the Roux limb to less tension on the gastrojejunal anastomosis than the antecolic-antegastric approach. The purpose of this study was to determine the incidence of stomal stenosis among patients who underwent a retrocolic-retrogastric Roux-en-Y gastric bypass. Between 2001 and 2004, 520 patients underwent a retrocolicretrogastric Roux-en-Y gastric bypass with gastric pouch size of 15 mL and Roux limb lengths of 75 or 150 cm. The gastroje- http://www.sages.org/ <strong>SAGES</strong> <strong>2005</strong> 185
- Page 1 and 2:
ABSTRACTS Thursday, April 14, 2005
- Page 3 and 4:
ABSTRACTS Thursday, April 14, 2005
- Page 5 and 6:
ABSTRACTS Thursday, April 14, 2005
- Page 7 and 8:
ABSTRACTS Thursday, April 14, 2005
- Page 9 and 10:
ABSTRACTS Thursday, April 14, 2005
- Page 11 and 12:
ABSTRACTS Thursday, April 14, 2005
- Page 13 and 14:
ABSTRACTS Thursday, April 14, 2005
- Page 15 and 16:
ABSTRACTS Thursday, April 14, 2005
- Page 17 and 18:
ABSTRACTS Friday, April 15, 2005 en
- Page 19 and 20:
ABSTRACTS Friday, April 15, 2005 an
- Page 21 and 22:
ABSTRACTS Friday, April 15, 2005 to
- Page 23 and 24:
ABSTRACTS Friday, April 15, 2005 to
- Page 25 and 26:
ABSTRACTS Friday, April 15, 2005 in
- Page 27 and 28:
ABSTRACTS Friday, April 15, 2005 co
- Page 29 and 30:
ABSTRACTS Friday, April 15, 2005 Co
- Page 31 and 32:
POSTER ABSTRACTS Posters of Distinc
- Page 33 and 34:
POSTER ABSTRACTS P076 MURPHY, JASON
- Page 35 and 36:
POSTER ABSTRACTS P152 CHOKKI, ADEL
- Page 37 and 38:
POSTER ABSTRACTS P235 YASUI, M “L
- Page 39 and 40:
POSTER ABSTRACTS P312 AGRESTA, FERD
- Page 41 and 42:
POSTER ABSTRACTS FUNDOPLICATION TO
- Page 43 and 44:
POSTER ABSTRACTS In two groups of 5
- Page 45 and 46:
POSTER ABSTRACTS Carvalho PhD, Debo
- Page 47 and 48:
POSTER ABSTRACTS tive procedures on
- Page 49 and 50:
POSTER ABSTRACTS invasive procedure
- Page 51 and 52: POSTER ABSTRACTS allows identificat
- Page 53 and 54: POSTER ABSTRACTS Laparoscopic gastr
- Page 55 and 56: POSTER ABSTRACTS Results: A total o
- Page 57 and 58: POSTER ABSTRACTS P054-Bariatric Sur
- Page 59 and 60: POSTER ABSTRACTS laparoscopic Gastr
- Page 61 and 62: POSTER ABSTRACTS P070-Bariatric Sur
- Page 63 and 64: POSTER ABSTRACTS becomes increasing
- Page 65 and 66: POSTER ABSTRACTS MD,Ajay K Chopra M
- Page 67 and 68: POSTER ABSTRACTS to have a fewer co
- Page 69 and 70: POSTER ABSTRACTS RESULTS: The mean
- Page 71 and 72: POSTER ABSTRACTS surgeons working i
- Page 73 and 74: POSTER ABSTRACTS One patient had un
- Page 75 and 76: POSTER ABSTRACTS operative time, na
- Page 77 and 78: POSTER ABSTRACTS divided to two maj
- Page 79 and 80: POSTER ABSTRACTS tomies during this
- Page 81 and 82: POSTER ABSTRACTS tumor. Discussion:
- Page 83 and 84: POSTER ABSTRACTS to avoid dissemina
- Page 85 and 86: POSTER ABSTRACTS sure of a gastric
- Page 87 and 88: POSTER ABSTRACTS subjects had used
- Page 89 and 90: POSTER ABSTRACTS (CS2) tasks, and 5
- Page 91 and 92: POSTER ABSTRACTS P180-Education/Out
- Page 93 and 94: POSTER ABSTRACTS laparoscopic equip
- Page 95 and 96: POSTER ABSTRACTS defined borders, a
- Page 97 and 98: POSTER ABSTRACTS B1.1?}0.3days, p =
- Page 99 and 100: POSTER ABSTRACTS P210-Hepatobiliary
- Page 101: POSTER ABSTRACTS P218-Basic Science
- Page 105 and 106: POSTER ABSTRACTS perforated. Result
- Page 107 and 108: POSTER ABSTRACTS J Lomax MD,Christi
- Page 109 and 110: POSTER ABSTRACTS METHODS: A databas
- Page 111 and 112: POSTER ABSTRACTS 3=severe). A total
- Page 113 and 114: POSTER ABSTRACTS silluminated the a
- Page 115 and 116: POSTER ABSTRACTS Introduction Radic
- Page 117 and 118: POSTER ABSTRACTS and GERD symptom s
- Page 119 and 120: POSTER ABSTRACTS performed followed
- Page 121 and 122: POSTER ABSTRACTS this practice by t
- Page 123 and 124: POSTER ABSTRACTS Esophageal aperist
- Page 125 and 126: POSTER ABSTRACTS were rejected for
- Page 127 and 128: POSTER ABSTRACTS LIHR group (27.5%
- Page 129 and 130: POSTER ABSTRACTS adhesion between p
- Page 131 and 132: POSTER ABSTRACTS P328-Hernia Surger
- Page 133 and 134: POSTER ABSTRACTS urement tools. Rat
- Page 135 and 136: POSTER ABSTRACTS CONCLUSION: The su
- Page 137 and 138: POSTER ABSTRACTS Results: 7 perfora
- Page 139 and 140: POSTER ABSTRACTS MS,Susan Hallbeck
- Page 141 and 142: POSTER ABSTRACTS All complications
- Page 143 and 144: POSTER ABSTRACTS In the past we foc
- Page 145 and 146: POSTER ABSTRACTS Materials and Meth
- Page 147 and 148: POSTER ABSTRACTS total traveling di
- Page 149 and 150: POSTER ABSTRACTS Patients in both g
- Page 151 and 152: POSTER ABSTRACTS P406-Solid Organ R
- Page 153 and 154:
POSTER ABSTRACTS stay period was 1.
- Page 155 and 156:
EMERGING TECHNOLOGY LUNCH ORAL ABST
- Page 157 and 158:
EMERGING TECHNOLOGY LUNCH ORAL ABST
- Page 159 and 160:
EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 161 and 162:
EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 163 and 164:
EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 165 and 166:
EMERGING TECHNOLOGY LUNCH POSTER AB
- Page 167 and 168:
EMERGING TECHNOLOGY LUNCH POSTER AB