Definitions of Bariatric Surgery CPT-4 Codes Description 43770
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Association Between Gastric Myoelectric Activity Disturbances and Dyspeptic T Symptoms in Gastrointestinal Cancer Patients ⁎ Aneta L
Advances in Medical Sciences 64 (2019) 44–53 Contents lists available at ScienceDirect Advances in Medical Sciences journal homepage: www.elsevier.com/locate/advms Original research article Association between gastric myoelectric activity disturbances and dyspeptic T symptoms in gastrointestinal cancer patients ⁎ Aneta L. Zygulskaa, , Agata Furgalab, Krzysztof Krzemienieckia,c,1, Beata Wlodarczykb, Piotr Thorb a Department of Oncology, University Hospital in Cracow, Cracow, Poland b Department of Pathophysiology, Jagiellonian University Medical College, Cracow, Poland c Department of Oncology, Jagiellonian University Medical College, Cracow, Poland ARTICLE INFO ABSTRACT Keywords: Purpose: Dyspeptic symptoms present a severe problem in gastrointestinal (GI) cancer patients. The aim of the Gastrointestinal carcinoma study was to analyze an association between gastric myoelectric activity changes and dyspeptic symptoms in Gastric motility gastrointestinal cancer patients. Gastric myoelectric activity Material and Methods: The study included 80 patients (37 men and 43 women, mean age 61.2 ± 7.8 years) Electrogastrography diagnosed with GI tract malignancies: colon (group A), rectal (group B) and gastric cancers (group C). Gastric Dyspeptic symptoms myoelectric activity in a preprandial and postprandial state was determined by means of a 4-channel electro- gastrography. Autonomic nervous system was studied based on heart rate variability analysis. The results were compared with the data from healthy asymptomatic controls. Results: In a fasted state, GI cancer patients presented with lesser percentages of normogastria time (A:44.23 vs. B:46.5 vs. C:47.10 vs. Control:78.2%) and average percentage slow wave coupling (ACSWC) (A:47.1 vs. B:50.8 vs. C:47.2 vs. Control:74.9%), and with higher values of dominant power (A:12.8 vs. -
Duodenal Switch. a Switch to the Duodenal Switch. A
Bariátrica & Metabólica Ibero-Americana (2019) 9.2.4: 2554-2563 Duodenal switch. A switch to the duodenal switch. A. Baltasar, N. Pérez, R. Bou, C. Serra Hospital "Virgen De Los Lirios De Alcoy”, Clínica San Jorge [email protected] 616.231.021 ABSTRACT: Background: The duodenal Switch (DS) combines a Sleeve-forming Keywords: gastrectomy (SFG) and a bilio-pancreatic diversion (BPD). Objectives: To report on 950 DS patients treated from 1994 to 2011. • Duodenal junction • Bariatric surgery Environment: Regional teaching hospital and private institution. • Vertical gastrectomy Methods: Prospective study of 950 consecutive patients treated with CD. • Bilio-pancreatic diversion • Poliphenols. Results: There were 518 open DS (ODS) and 432 laparoscopic DS (LDS). Surgical mortality of 0.73% (1.6% in CDA and 0.47% in CDL), 4.84% incidence of leakage, two liver failure (0.2%) and protein calorie malnutrition (PCM) in 3.1%. At 5 years, the %EWL drops by 80% and the Expected BMI by 100%. Conclusions: The CD is the most aggressive bariatric technique, with the best long-term weight loss. Operative complications and long-term follow-up guidelines are described. The aim is to change the bariatric techniques to accept the CD. 2555 Bariátrica & Metabólica Ibero-Americana (2019) 9.2.4: 2554-2563 Introduction Description of surgical techniques The Duodenal Switch (DS) is a mixed operation that consists Open DS (ODS) by transverse laparotomy of two techniques, a gastric surgery, the Sleeve-forming The patient is in Trendelenburg position. A transverse Vertical Gastrectomy (SFG) to reduce intake and also an supraumbilical incision is made between both costal intestinal surgery, the bilio-pancreatic diversion (BPD) that margins (Fig.2 a-b). -
About Your Gastrectomy Surgery
Patient & Caregiver Education About Your Gastrectomy Surgery About Your Surgery .................................................................................................................3 Before Your Surgery .................................................................................................................5 Preparing for Your Surgery ............................................................................................................6 Common Medications Containing Aspirin and Other Nonsteroidal Anti-inflammatory Drugs (NSAIDs) ............................................................... 14 Herbal Remedies and Cancer Treatment ................................................................................ 19 Information for Family and Friends for the Day of Surgery ............................................22 After Your Surgery .................................................................................................................27 What to Expect ............................................................................................................................... 28 How to Use Your Incentive Spirometer .................................................................................. 32 Patient-Controlled Analgesia (PCA) ....................................................................................... 35 Eating After Your Gastrectomy ..................................................................................................37 Resources ................................................................................................................................53 -
Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis
ORIGINAL ARTICLE pISSN 2234-778X •eISSN 2234-5248 J Minim Invasive Surg 2015;18(2):48-52 Journal of Minimally Invasive Surgery Laparoscopic Truncal Vagotomy and Gatrojejunostomy for Pyloric Stenosis Jung-Wook Suh, M.D.1, Ye Seob Jee, M.D., Ph.D.1,2 Department of Surgery, 1Dankook University Hospital, 2Dankook University School of Medicine, Cheonan, Korea Purpose: Peptic ulcer disease (PUD) remains one of the most prevalent gastrointestinal diseases and Received January 27, 2015 an important target for surgical treatment. Laparoscopy applies to most surgical procedures; however Revised 1st March 9, 2015 its use in elective peptic ulcer surgery, particularly in cases of pyloric stenosis, has not been popular. 2nd March 28, 2015 The aim of this study was to describe the role of laparoscopic surgery and an easily performed Accepted April 20, 2015 procedure for pyloric stenosis. We accordingly performed laparoscopic truncal vagotomy with gastrojejunostomy in 10 consecutive patients with pyloric stenosis. Corresponding author Ye Seob Jee Methods: Data were collected prospectively from all patients who underwent laparoscopic truncal Department of Surgery, Dankook vagotomy with gastrojejunostomy from August 2009 to May 2014 and reviewed retrospectively. University Hospital, Dankook Results: A total of 10 patients underwent laparoscopic trucal vagotomy with gastrojejunostomy for University School of Medicine, 119, peptic ulcer obstruction from August 2009 to May 2014 in ○○ university hospital. The mean age was Dandae-ro, Dongnam-gu, Cheonan 62.6 (±16.4) years old and mean BMI was 19.3 (±2.5) kg/m2. There were no conversions to open 330-714, Korea surgery and no occurrence of intra-operative complications. -
Thoracoscopic Truncal Vagotomy Versus Surgical Revision of the Gastrojejunal Anastomosis for Recalcitrant Marginal Ulcers
Surgical Endoscopy (2019) 33:607–611 and Other Interventional Techniques https://doi.org/10.1007/s00464-018-6386-7 2018 SAGES ORAL DYNAMIC Thoracoscopic truncal vagotomy versus surgical revision of the gastrojejunal anastomosis for recalcitrant marginal ulcers Alicia Bonanno1 · Brandon Tieu2 · Elizabeth Dewey1 · Farah Husain3 Received: 1 May 2018 / Accepted: 10 August 2018 / Published online: 21 August 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Introduction Marginal ulcer is a common complication following Roux-en-Y gastric bypass with incidence rates between 1 and 16%. Most marginal ulcers resolve with medical management and lifestyle changes, but in the rare case of a non-healing marginal ulcer there are few treatment options. Revision of the gastrojejunal (GJ) anastomosis carries significant morbidity with complication rates ranging from 10 to 50%. Thoracoscopic truncal vagotomy (TTV) may be a safer alternative with decreased operative times. The purpose of this study is to evaluate the safety and effectiveness of TTV in comparison to GJ revision for treatment of recalcitrant marginal ulcers. Methods A retrospective chart review of patients who required surgical intervention for non-healing marginal ulcers was performed from 1 September 2012 to 1 September 2017. All underwent medical therapy along with lifestyle changes prior to intervention and had preoperative EGD that demonstrated a recalcitrant marginal ulcer. Revision of the GJ anastomosis or TTV was performed. Data collected included operative time, ulcer recurrence, morbidity rate, and mortality rate. Results Twenty patients were identified who underwent either GJ revision (n = 13) or TTV (n = 7). There were no 30-day mortalities in either group. -
Effects of Sleeve Gastrectomy Plus Trunk Vagotomy Compared with Sleeve Gastrectomy on Glucose Metabolism in Diabetic Rats
Submit a Manuscript: http://www.f6publishing.com World J Gastroenterol 2017 May 14; 23(18): 3269-3278 DOI: 10.3748/wjg.v23.i18.3269 ISSN 1007-9327 (print) ISSN 2219-2840 (online) ORIGINAL ARTICLE Basic Study Effects of sleeve gastrectomy plus trunk vagotomy compared with sleeve gastrectomy on glucose metabolism in diabetic rats Teng Liu, Ming-Wei Zhong, Yi Liu, Xin Huang, Yu-Gang Cheng, Ke-Xin Wang, Shao-Zhuang Liu, San-Yuan Hu Teng Liu, Ming-Wei Zhong, Xin Huang, Yu-Gang Cheng, reviewers. It is distributed in accordance with the Creative Ke-Xin Wang, Shao-Zhuang Liu, San-Yuan Hu, Department Commons Attribution Non Commercial (CC BY-NC 4.0) license, of General Surgery, Qilu Hospital of Shandong University, Jinan which permits others to distribute, remix, adapt, build upon this 250012, Shandong Province, China work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and Yi Liu, Health and Family Planning Commission of Shandong the use is non-commercial. See: http://creativecommons.org/ Provincial Medical Guidance Center, Jinan 250012, Shandong licenses/by-nc/4.0/ Province, China Manuscript source: Unsolicited manuscript Author contributions: Liu T, Liu SZ and Hu SY designed the study and wrote the manuscript; Liu T and Zhong MW instructed Correspondence to: San-Yuan Hu, Professor, Department of on the whole study and prepared the figures; Liu Y and Wang KX General Surgery, Qilu Hospital of Shandong University, No. 107, collected and analyzed the data; Liu T, Huang X and Cheng YG Wenhua Xi Road, Jinan 250012, Shandong Province, performed the operations and performed the observational study; China. -
Adjustable Gastric Banding
7 Review Article Page 1 of 7 Adjustable gastric banding Emre Gundogdu, Munevver Moran Department of Surgery, Medical School, Istinye University, Istanbul, Turkey Contributions: (I) Conception and design: All authors; (II) Administrative support: All authors; (III) Provision of study materials or patients: All authors; (IV) Collection and assembly of data: All authors; (V) Data analysis and interpretation: All authors; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. Correspondence to: Emre Gündoğdu, MD, FEBS. Assistant Professor of Surgery, Department of Surgery, Medical School, Istinye University, Istanbul, Turkey. Email: [email protected]; [email protected]. Abstract: Gastric banding is based on the principle of forming a small volume pouch near the stomach by wrapping the fundus with various synthetic grafts. The main purpose is to limit oral intake. Due to the fact that it is a reversible surgery, ease of application and early results, the adjustable gastric band (AGB) operation has become common practice for the last 20 years. Many studies have shown that the effectiveness of LAGB has comparable results with other procedures in providing weight loss. Early studies have shown that short term complications after LAGB are particularly low when compared to the other complicated procedures. Even compared to RYGB and LSG, short-term results of LAGB have been shown to be significantly superior. However, as long-term results began to emerge, such as failure in weight loss, increased weight regain and long-term complication rates, interest in the procedure disappeared. The rate of revisional operations after LAGB is rapidly increasing today and many surgeons prefer to convert it to another bariatric procedure, such as RYGB or LSG, for revision surgery in patients with band removed after LAGB. -
Clinical Policy: Bariatric Surgery Reference Number: NH
Clinical Policy: Bariatric Surgery Reference Number: NH. CP.MP.37 Coding Implications Effective Date: 06/09 Revision Log Last Review Date: 04/18 See Important Reminder at the end of this policy for important regulatory and legal information. Description There are two categories of bariatric surgery: restrictive procedures and malabsorptive procedures. Gastric restrictive procedures include procedures where a small pouch is created in the stomach to restrict the amount of food that can be eaten, resulting in weight loss. The laparoscopic adjustable gastric banding (LAGB) and laparoscopic sleeve gastrectomy (LSG) are examples of restrictive procedures. Malabsorptive procedures bypass portions of the stomach and intestines causing incomplete digestion and absorption of food. Duodenal switch is an example of a malabsorptive procedure. Roux-en-y gastric bypass (RYGB), biliopancreatic diversion with duodenal switch (BPD-DS), and biliopancreatic diversion with gastric reduction duodenal switch (BPD-GRDS) are examples of restrictive and malabsorptive procedures. LAGB devices are currently not FDA approved for adolescents less than 18 years, but an industry- sponsored prospective study is in progress, and numerous retrospective studies of adolescents have been published with favorable results. Policy/Criteria It is the policy of NH Healthy Families that the bariatric surgery procedures LAGB, LSG, and laparoscopic RYGB for adolescents and adults and laparoscopic BPD-DS/BPD-GRDS for adults are medically necessary when meeting the following criteria under section I through III: I. Participating providers that are MBSAQIP (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program for the American College of Surgeons) accredited have demonstrated a commitment to excellence in ethics, quality and patient care. -
A Matched Cohort Analysis of Single Anastomosis Loop Duodenal Switch Versus Roux-En-Y Gastric Bypass with 18-Month Follow-Up - Springer
A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up - Springer Search Submit Article Surgical Endoscopy pp 1-7 First online: 22 December 2015 A matched cohort analysis of single anastomosis loop duodenal switch versus Roux-en-Y gastric bypass with 18-month follow-up Austin Cottam, Daniel Cottam , Walter Medlin, Christina Richards, Samuel Cottam, Hinali Zaveri, Amit Surve 10.1007/s00464-015-4707-7 Copyright information Abstract Background The Roux-en-Y gastric bypass (GBP) has been considered the gold standard for many years. The loop duodenal switch (LDS) is a relatively new procedure that simplifies the complexity of the duodenal switch (BPDDS) by making it a single anastomosis procedure while at the same time giving it more intestinal absorption to reduce the rates of malnutrition associated with traditional BPDDS. This paper seeks to compare the 18-month weight loss outcomes and complications of the more standard GBP with the newer LDS in a single US center. Methods A retrospective matched cohort was analyzed on 108 patients who had either GBP (54 patients) or LDS (54 patients). Regression analysis was used to compare weight loss outcomes as measured by BMI and weight loss percentages. Complications gathered included bleeds, reoperations, diagnostic or therapeutic endoscopy (EGD), ulcers and chronic nausea. Results GBP and LDS have statistically similar weight loss at 18 months (39.6 vs 41 % weight loss, respectively). However, there were significantly more nausea complaints (26 vs 5), diagnostic endoscopies (EGD) (21 vs 3) and ulcers (6 vs 0) with the GBP than the LDS. -
Gastroenterostomy and Vagotomy for Chronic Duodenal Ulcer
Gut, 1969, 10, 366-374 Gut: first published as 10.1136/gut.10.5.366 on 1 May 1969. Downloaded from Gastroenterostomy and vagotomy for chronic duodenal ulcer A. W. DELLIPIANI, I. B. MACLEOD1, J. W. W. THOMSON, AND A. A. SHIVAS From the Departments of Therapeutics, Clinical Surgery, and Pathology, The University ofEdinburgh The number of operative procedures currently in Kingdom answered a postal questionnaire. Eight had vogue in the management of chronic duodenal ulcer died since operation, and three could not be traced. The indicates that none has yet achieved definitive status. patients were questioned particularly with regard to Until recent years, partial gastrectomy was the eating capacity, dumping symptoms, vomiting, ulcer-type dyspepsia, diarrhoea or other change in bowel habit, and favoured operation, but an increasing awareness of a clinical assessment was made based on a modified its significant operative mortality and its metabolic Visick scale. The mean time since operation was 6-9 consequences, along with Dragstedt and Owen's years. demonstration of the effectiveness of vagotomy in Thirty-five patients from this group were admitted to reducing acid secretion (1943), has resulted in the hospital for a full investigation of gastrointestinal and widespread use of vagotomy and gastric drainage. related function two to seven years following their The success of duodenal ulcer surgery cannot be operation. Most were volunteers, but some were selected judged only on low stomal (or recurrent) ulceration because of definite complaints. There were more females rates; the other sequelae of gastric operations must than males (21 females and 14 males). The following be considered. -
Laparoscopic Bariatric Surgery Manual
Laparoscopic Bariatric Surgery Manual The Center for Bariatrics & Healthy Weight 11 Upper Riverdale Road, SW Surgery Suites – Women’s Center Ground Floor Riverdale, GA 30274 Office: 770-897-SLIM (7546) Fax: 770-996-3941 1 | P a g e Dr. Karleena Tuggle, M.D., F.A.C.S Board-certified Bariatric Surgeon 2 | P a g e What is the Process? Before Surgery • Information Seminar • Initial consultation • Insurance verified and clearances reviewed with Patient Advocate • Nutritional consultation and completion of any required weight loss visits • Completion of all other required appointments/clearances • Support group participation Around the time of Surgery • Pre-op appointment with Surgeon 2 weeks before surgery • Endoscopy (EGD) 1-2 weeks before surgery with surgeon • Bariatric surgery performed After Surgery • 2 week post-operative appointment with surgeon o When applicable 1 week appointment for drain removal • 6 week post-operative appointment with health care provider • 3-6 months: appointments with health care provider, nutritionist, exercise physiologist, mental health professional, support groups as needs are identified • 6 months and yearly appointments: check up with health care provider • At a minimum yearly appointments should be continued indefinitely where we check weight goals, blood lab work and overall health 3 | P a g e Table of Contents Page Morbid Obesity and Bariatric Surgery 5-6 Signs and Symptoms of Complications 6-8 Recommended Vitamin Regimen 8-11 How to Prepare for Weight Loss Surgery 11-12 2 Day Clear Liquid Diet 13 Morning -
Chapter 1 History of Laparoscopic Surgery
Chapter 1 History of Laparoscopic Surgery Kiyokazu Nakajima, Jeffrey W. Milsom, and Bartholomäus Böhm Although laparoscopic surgery has transformed surgery only in the past two decades, its evolution is only the natural byproduct of the medical doctor’s curiosity to directly visualize and treat surgical dis- eases. The earliest known attempts to look inside the living human body date from 460 to 375 BC, from the Kos school of medicine led by Hippocrates in Greece.1,2 They described a rectal examination using a speculum remarkably similar to the instruments we use today. Similar specula were discovered in the ruins of Pompeii (70 AD) that were used to examine the vagina, the cervix, and the rectum, and obtain an inside view of the nose and ear.1 The Babylonian Talmud written in 500 AD described a lead siphon, named “Siphophert,” with a mouthpiece, which was bent inward and held a mechul (wooden drain).1,3 The apparatus was introduced into the vagina and was used to differentiate between vaginal and uterine bleeding. During these early years ambient light was used. The term “endoscopein” is attributed to Avicenna (Ibn Sina, 980–1037 AD) of Persia, although an Arabian physician, Albulassim (912–1013 AD), who placed a mirror in front of the exposed vagina, was the fi rst to use refl ected light as a source of illumination for an endoscopic examination. Giulio Caesare Aranzi in Venice (1530–1589) developed the fi rst endoscopic light in 1587. He used the Benedictine monk Don Panuce’s principle of the “camera obscura” for medical purposes – the