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A C Wittgrove

Publications and source records attributed to A C Wittgrove.

8 recordsLinked to original sources
PubMed2001

Combined laparoscopic/endoscopic anvil placement for the performance of the gastroenterostomy.

BACKGROUND: We developed the laparoscopic gastric bypass in 1993 and first reported the technique and results in 1994. The technique for the gastroenterostomy was derived from the method used in the percutaneous endoscopic gastrostomy tube placement. Some have questioned the safety of this technique, and alternatives have been proposed. METHOD: Prospectively, we have followed and recorded the results of our laparoscopic patients. To date we have performed over 1,400 laparoscopic gastric bypass operations using the same technique of anvil placement: pulling the anvil down from the mouth to the stomach pouch with a percutaneously placed wire. All patients underwent upper GI endoscopy following the anvil placement, and a water-soluble upper GI series was obtained on the first postoperative day. RESULTS: There have been no esophageal injuries in the first 1400 patients on whom this technique was done. CONCLUSION: The percutaneous pull-wire technique is a safe and effective method to place the 21-mm circular stapler anvil for the performance of a laparoscopic gastroenterostomy.

Gastroenterostomy↗
PubMed2000

Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3-60 month follow-up.

BACKGROUND: The authors have performed the laparoscopic gastric bypass since 1993 and perform about one-half of bariatric cases laparoscopically. Since our initial report, several groups throughout the world have preformed the gastric bypass laparoscopically, with various modifications. METHOD: Prospectively, we followed and recorded the results of our laparoscopic patients. A detailed pre- and post-operative analysis of the patient's co-morbidities is performed as well as complete weight and laboratory data evaluation. RESULTS: With > 80% follow-up, we found an excess weight loss of about 80% by the first year. This degree of loss is well sustained. Over 95% of the significant pre-operative co-morbidities are controlled. CONCLUSION: The laparoscopic gastric bypass has been refined over 5 years of use. Though we have not changed the basic operation as we originally described, others have modified the various anastomotic techniques. The weight loss results are very good to excellent, with patients now out to "long-term" follow-up. Resolution of the co-morbidities is documented. The operation has an adequate track record to show effectiveness, and training programs should be established to maximize safety.

Anastomosis, Roux-en-Y↗
PubMed1998

Laparoscopic gastric bypass for morbid obesity in a patient with situs inversus.

The purpose of this article is to discuss the operative challenges posed by the advanced laparoscopic approach to a patient with situs inversus. The patient is a morbidly obese woman who has multiple co-morbidities related to her weight and who presented for bariatric surgery. A laparoscopic gastric by-pass was successfully performed. Situs inversus totalis is not a contraindication for laparoscopic surgery.

Adult↗
PubMed1998

Pregnancy following gastric bypass for morbid obesity.

BACKGROUND: Women who suffer from morbid obesity are often infertile. If these women are able to become pregnant, they are considered high risk because of the hypertension, diabetes and other associated risk factors. Following the pregnancy is difficult due to limitations of the physical examinations. More costly ultrasound examinations are needed at a higher frequency. Bariatric surgery reduces the woman's weight and the incidence of obesity related co-morbidities. The number of pregnancies and rate of complications during those pregnancies in our post-bariatirc surgical patients were evaluated. METHOD: Our group has been doing bariatric surgery since the early 1980s. We have over 2000 active patients on our current newsletter mailing list. The patients also have a series of networks through support groups. The patients are informed to contact us when they become pregnant so we may assist the obstetrician with their care. Through these various means, we have been able to identify 41 women in our patient population who have become pregnant. Using personal interview, questionnaire, and review of perinatal records, pregnancy-related risks and complications were studied. RESULTS: With over a 95% follow-up rate on the patients identified as having been pregnant following surgery, we found less risk of gestational diabetes, macrosomia, and cesarean section than associated with obesity. There were no patients with clinically significant anemia. CONCLUSION: Since the patients had an operation that restricts their food intake, some basic precautions should be taken when they become pregnant. With this in mind, our patients have done well with their pregnancies. The post-surgical group had fewer pregnancy-related complications than did an internally controlled group that were morbidly obese during their previous pregnancies.

Female↗