Divided vertical banded gastroplasty either for correction or as a first-choice operation

Surgical treatment for morbid obesity: the laparoscopic Roux-en-Y gastric bypass

Over the past 20 years bariatric surgery proved to be a valid treatment for reduction and elimination of obesity-related diseases and long-term sustainable weight loss. Minimally invasive or laparoscopic techniques such as laparoscopic Roux-en-Y (LRNY) have replaced open procedures. Many factors play important roles in the small intricacies and variations of the procedure, chief of which is the creation and size of the gastrojejunostomy. Regardless of the variations in technique, the LRNY remains the gold standard for the surgical treatment of clinically severe or morbid obesity, with relatively low morbidity and mortality.

Hand-assisted laparoscopic surgery: an overview

BACKGROUND

Advanced laparoscopic surgery is complex and time-consuming. Achieving consistent efficacy and safety throughout the entire procedure is always a problem. For this reason, hand-assisted laparoscopic surgery (HALS) was developed.

METHODS

Devices were designed to allow manual access to the abdomen through the utility laparotomy. By using one hand in the abdomen during laparoscopy, the surgeon regains direct tactile sensation and acquires improved hand-eye coordination. The safety of the individual devices has been tested in RCT for the registration of the individual devices. An index known as Surgical Action Efficiency was calculated for in six patients undergoing laparoscopic colon resection and six patients with hand-assisted colon resections.

RESULTS

All of the registered devices are safe. Surgical Action Efficiency for the laparoscopy group was 55 +/- 14%; for the HALS group, it was 71 +/- 4%. This result is statistically significant (p < 0.05).

CONCLUSION

HALS is a safe and efficient method by which it is possible to combine the established convenience and safety of open surgery with the advantages of minimally invasive surgery.