Ida Camperchioli

Laparoscopic single-port sleeve gastrectomy for morbid obesity: preliminary series.

BACKGROUND Laparoscopic sleeve gastrectomy has been recently proposed as a sole bariatric procedure because of the resulting considerable weight loss in morbidly obese patients. Traditionally, laparoscopic sleeve gastrectomy requires 5-6 skin incisions to allow for placement of multiple trocars. With the introduction of single-incision laparoscopic surgery, multiple abdominal procedures have been performed using a sole umbilical incision, with good cosmetic outcomes. The purpose of our study was to evaluate the feasibility and safety of laparoscopic single incision sleeve gastrectomy for morbid obesity. METHODS A total of 8 consecutive patients underwent laparoscopic single-incision sleeve gastrectomy at the Operative Unit of Bariatric Surgery of the University of Rome Tor Vergata from March 2009 to June 2009. RESULTS Of the 8 patients, 5 were women and 3 were men, with a mean age of 44.4 years. The mean preoperative body mass index was 56.2 kg/m(2). The mean operative time was 128 minutes. The mean postoperative stay was 2.4 days. The mean postoperative body mass index was 49.3 kg/m(2) at a mean follow-up period of 3.6 months. The mean percentage of excess weight loss was 33% for the same period. CONCLUSIONS Laparoscopic single-incision sleeve gastrectomy seems to be safe, technically feasible, and reproducible. A randomized trial comparing single-incision sleeve gastrectomy and conventional sleeve gastrectomy might be needed to evaluate the postoperative results in relation to the development of abdominal wall complications.

Intragastric Balloon Followed by Biliopancreatic Diversion in a Liver Transplant Recipient: A Case Report

Liver transplantation is a life-saving procedure for end-stage liver disease. In liver transplant recipients, morbid obesity influences post-operative survival and graft function. In 1996, our patient underwent a successful liver transplantation because of a HCV-related liver failure (body mass index (BMI) 31). Follow-up showed a functional graft and the development of severe obesity up to a BMI of 61 in January 2006. In January 2007, he was submitted to intragastric balloon therapy for 6 months, reaching a BMI of 54. In September 2007, he underwent a biliopancreatic diversion. During follow-up to March 2008, he reached a BMI of 42 with ameliorations of comorbidities. In May 2008, during a hospital admission, he suddenly died of a heart attack. Post mortem study revealed a myocardial infarction. This is the first world case report for this approach. According to our opinion, patient’s death was not related to bariatric surgery.

Laparoscopic treatment of a huge mesenteric chylous cyst.

Mesenteric chylous cysts are rare. This study suggests that even large mesenteric chylous cysts may be managed with minimally invasive means.

Surgical risk and technical notes of laparoscopic anterior resection in the elderly: lessons from an early experience

Background The many advantages and the few limits of laparoscopic surgery have already been demonstrated, but its role in colorectal surgical oncology are all but cleared. However, recent series show that shortand long-term results are the same of traditional surgery. Some concern still remains on the safety of laparoscopic oncologic surgery in aged patients with their expected comorbidity. But elderly patients are those in whom a mini-invasive approach could be most beneficial.