2005 SAGES Abstracts

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POSTER ABSTRACTS <strong>SAGES</strong> <strong>2005</strong> P001–Posters of Distinction HIATAL CRURAL REPAIR AS MANAGEMENT OF SEVERE REFLUX FOLLOWING LAPAROSCOPIC ADJUSTABLE GASTRIC BANDING, GEORGE A FIELDING, WESLEY HOSPITAL, BRIS- BANE, AUSTRALIA The majority of symptomatic failures leading to removal of laparoscopic adjustable gastric bands (LAGB), previously 5% in this series of 2,450 LAGB’S, are due to reflux or dysphagia. Many have normal barium studies at band removal despite severe symptoms. Recently it was realised that these patients had large hiatal crural defects. They are now offered crural repair and repair of slip if indicated, rather than band removal, on the presumption that this was the cause of their symptoms. Twenty-three patients presented with severe reflux a mean 44 +/- 22 months (10-101) after LAGB. At time of banding mean weight was 131 +/- 29 kg (90-211), mean BMI 44 +/- 9 kg/m2 (35- 62). All were on PPI’s, 9 were considering band removal, 4 had severe dysphagia. Barium studies showed normal 8, hiatus hernia/concentric dilatation 9, slip 6. At presentation, mean weight was 90 +/- 20 kg (73-154), BMI 34 +/- 5 kg/m2 (24-44) and EWL 51 +/- 20% (21-91). They had 15 +/- 9 visits (5-32) since banding and mean fill of only 1 cc. - 9 patients had empty bands. Three patients had failed weight loss - 20% EWL, empty band, 20 visits, due to inability to tolerate band tightening. Crural repair alone was performed in 13 patients, with change to an 11cm band in the 4 with severe dysphagia and with repair of concurrent slip in 6 patients. Mean follow-up is 13 +/- 12 months (4-39), weight 95 +/- 16 kg, BMI 33 +/- 4 kg/ms, EWL 54 +/- 18%. There have been a mean 4 post-op visits, with 2 +/- 0.7 cc fill in the standard bands. All 23 patients are asymptomatic, off PPI’s and happy with the band. There have been no band removals in the last 14 months, compared to mean 10 per year previously. Many of the symptomatic failures of LAGB due to reflux and dysphagia may be due to undiagnosed hiatal hernia or large crural defects that have previously been filled with fat. Repair of these defects will cure reflux symptoms and greatly reduce the need for band removal. Furthermore, patients can then have their bands tightened appropriately. These large crural defects should be sought at the original LAGB surgery and repaired. P002–Posters of Distinction EFFECT ON ANASTOMOTIC LEAK RATE WITH THE USE OF CONTINUOUS POSITIVE AIRWAY PRESSURE IN ROUX-EN-Y GASTRIC BYPASS PATIENTS, Stephen Kolakowski Jr. MD, Alan L Schuricht MD,David S Wernsing MD,Matt L Kirkland MD, Pennsylvania Hospital OBJECTIVE: The purpose of this study was to assess the effect of postoperative continuous positive airway pressure (CPAP) on anastomotic leak rates in patients undergoing roux-en-y gastric bypass. In addition, a comparison was made between those patients who were supported using their personal CPAP units and those using hospital-supplied units. MATERIALS AND METHODS: Eight hundred fifty two consecutive patients undergoing roux-en-y gastric bypass at our institution between January 2001 and December 2003 were included. Four hurndred ten of these patients were previously diagnosised with obstructive sleep apnea (OSA) and 104 were CPAP dependent. The patients were then stratified into 4 groups: Non OSA, OSA without CPAP, hospital-issued CPAP and patient?s own CPAP. Clinical outcomes were compared between groups using a one way ANOVA test. RESULTS: Postoperatively, 24 anastomatic leaks (2.81%) were identified. When comparing all cpap patients vs. non cpap patients, there was no statistically significant difference in the number of leaks observed. The intragroup leak rates were Non OSA (13/443) (2.93%), OSA without CPAP (6/306) (1.96%), Hospital CPAP (4/24) (16.7%), and own CPAP (1/80) (1.25%). Between group analysis revealed significantly higher leak rates with mean differences between: Hospital CPAP vs. own CPAP (.1542) (p-value
POSTER ABSTRACTS In two groups of 56 LGB and 70 OGB patients, there were no differences in demographics, preop BMI, distribution of BMI, or incidence of comorbidities. The overall risk of having a postoperative complication was greater for OGB patients than LGB patients (57.1% vs. 14.3%, p
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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
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Page 65 and 66: POSTER ABSTRACTS MD,Ajay K Chopra M
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Page 69 and 70: POSTER ABSTRACTS RESULTS: The mean
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Page 79 and 80: POSTER ABSTRACTS tomies during this
Page 81 and 82: POSTER ABSTRACTS tumor. Discussion:
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POSTER ABSTRACTS laparoscopic equip
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POSTER ABSTRACTS defined borders, a
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POSTER ABSTRACTS B1.1?}0.3days, p =
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POSTER ABSTRACTS P210-Hepatobiliary
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POSTER ABSTRACTS P218-Basic Science
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POSTER ABSTRACTS P225-Complications
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POSTER ABSTRACTS perforated. Result
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POSTER ABSTRACTS J Lomax MD,Christi
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POSTER ABSTRACTS METHODS: A databas
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POSTER ABSTRACTS 3=severe). A total
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POSTER ABSTRACTS silluminated the a
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POSTER ABSTRACTS Introduction Radic
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POSTER ABSTRACTS and GERD symptom s
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POSTER ABSTRACTS performed followed
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POSTER ABSTRACTS this practice by t
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POSTER ABSTRACTS Esophageal aperist
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POSTER ABSTRACTS were rejected for
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POSTER ABSTRACTS LIHR group (27.5%
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POSTER ABSTRACTS adhesion between p
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POSTER ABSTRACTS P328-Hernia Surger
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POSTER ABSTRACTS urement tools. Rat
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POSTER ABSTRACTS CONCLUSION: The su
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POSTER ABSTRACTS Results: 7 perfora
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POSTER ABSTRACTS MS,Susan Hallbeck
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POSTER ABSTRACTS All complications
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POSTER ABSTRACTS In the past we foc
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POSTER ABSTRACTS Materials and Meth
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POSTER ABSTRACTS total traveling di
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POSTER ABSTRACTS Patients in both g
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POSTER ABSTRACTS P406-Solid Organ R
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POSTER ABSTRACTS stay period was 1.
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EMERGING TECHNOLOGY LUNCH ORAL ABST
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EMERGING TECHNOLOGY LUNCH POSTER AB
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2005 SAGES Abstracts

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