PubMed Health⌕ Search

Biomedical subjects

Johan Raeder

Publications and source records attributed to Johan Raeder.

11 recordsLinked to original sources

[Laparoscopic gastric bypass surgery in extreme overweight at a private hospital].

BACKGROUND: Laparoscopic gastric bypass surgery leads to significant weight loss and reduced morbidity in patients with severe obesity. The technique was introduced at the private Aleris hospital the autumn 2005. We here present the method and results from our initial experience. MATERIAL AND METHODS: Inclusion criteria were BMI > 40 kg/m2 or BMI 35-39,9 kg/m2 , with obesity-related co-morbidity for more than 5 years and insufficient effect of conservative treatment. The first 121 (103 women) consecutive patients who underwent gastric bypass surgery at Aleris Hospital were included. Characteristics were; mean age 40 years (18-68), mean preoperative body weight 134 kg (91-211) and BMI 44 m/kg 2 (35-64). Serious complications or major morbidity were defined as anastomosis- or intestinal leakage and bleeding requiring surgical treatment. RESULTS: No deaths or major morbidity was observed the first 30 days after surgery. One patient underwent successful surgery of a perforated ulcer localized distally to the gastro-jejunal anastomoses 3 months p.o. Mean operating time was 62 min (40-124) for patients who underwent isolated laparoscopic bypass. The mean hospitalisation time was 2.9 days (2-6). CONCLUSION: Our results demonstrate that bariatric surgery can be established successfully with a low rate of perioperative complications. We believe that thorough planning and experienced bariatric surgeons contribute to our favourable results. .

Adolescent↗

Regional anaesthesia in ambulatory surgery.

PURPOSE OF REVIEW: The purpose of this review is to present recent research into the clinical use of regional anaesthesia techniques in ambulatory surgery. Further, to put into an ambulatory perspective some of the issues recently discussed on the basis and practice of regional anaesthesia in general. RECENT FINDINGS: Early discharge with long-acting peripheral nerve blockade seems safe, and discharge of patients who have not voided after surgery is possible under specified terms. The spinal anaesthesia technique may be improved in terms of better and faster recovery characteristics if the dose of local anaesthesia is reduced by adding a small dose of opioid. SUMMARY: Loco-regional techniques are well suited for ambulatory surgery due to less postoperative nausea and pain and possibly less cognitive dysfunction. The different techniques are continuously being refined in order to provide fast discharge readiness, while still maintaining the benefits.

Journal Article↗

[Outpatient laparoscopic fundoplication for gastroesophageal reflux disease].

BACKGROUND: Day-case laparoscopic fundoplication for gastro-oesophageal reflux disease was introduced in January 1997. MATERIAL AND METHODS: Inclusion criteria were ASA grade 1-2, living within 30 minutes by car from the hospital, or staying over in the patient hotel the first night, with company. Initially, only selected patients were offered day-case treatment; later it was adopted as routine. The patients underwent general intravenous anaesthesia with propofol and remifentanil and were given prophylaxis against postoperative pain and nausea. The surgical procedure was Nissen-Rossetti fundoplication or semifundoplication. RESULTS: 83 patients were included. Ten patients were admitted, 73 (88%) were discharged as planned 3-8 hours after the operation. Eight patients (10%) were readmitted; one of them underwent reoperation for necrosis of the gastric fundus. Eight patients visited the outpatient department without need for readmission. At seven-day follow-up, 55 discharged patients (75%) were satisfied with the day-case treatment, nine (12%) were indifferent, and nine (12%) were dissatisfied, mostly because of pain. If offered a similar operation in the future, 50 patients (68%) would have preferred and 11 (15%) would have accepted day-case treatment; 12 (16%) would not. INTERPRETATION: Outpatient laparoscopic fundoplication is safe and well tolerated by the majority of patients.

Ambulatory Surgical Procedures↗