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K Gawdat

Publications and source records attributed to K Gawdat.

4 recordsLinked to original sources
PubMed2000

Bariatric re-operations: are they preventable?

BACKGROUND: Many operations are currently used for morbid obesity, and every procedure appears to have advantages, drawbacks and failures. Re-operation is a part of bariatric surgery practice that is necessary in the event of failure. We analyzed the reasons for failure in the bariatric re-operation group. METHODS: From June 1998 to April 2000, 17 morbidly obese patients had a bariatric re-operation. Of 203 bariatric operations performed in our institution, 12 patients had a re-operation (5.9%), and 5 patients had their primary procedure performed elsewhere. Mean age was 36.5 +/- 11 years, mean original weight 151.3 +/- 44.3 kg, mean BMI 58.4 +/- 16.9 kg/m2 and mean excess body weight (EBW) 94.4 +/- 43.5 kg. Mean height was 161 +/- 7.7 cm, and 15 patients were female (88.2%). The primary bariatric operation was vertical banded gastroplasty (VBG) in 15 patients (88.2%), Roux-en-Y gastric bypass (RYGBP) in 1 patient (5.9%), and gastric banding in 1 patient (5.9%). Duration since the primary surgery was a mean of 15.6 months (range 1-72 months). RESULTS: Reasons for re-operation were inadequate weight loss (47%) or food intolerance (53%). 11 patients had VBG converted to RYGBP, 1 patient had a gastric banding converted to a BPD, 4 patients had their VBG converted to a gastro-gastrostomy, and 1 patient had a RYGBP staple dehiscence re-stapled. CONCLUSION: Incidence of bariatric re-operations may be decreased if super-obese patients, older patients, and sweets-consuming individuals undergo RYGBP or BPD as the primary operation rather than VBG or gastric banding. The use of staplers transecting and separating the gastric pouch from the remaining stomach can decrease staple dehiscence.

Adult↗
PubMed1999

Gastric restrictive procedures through a mini-incision: a cost-effective alternative to laparoscopic bariatric surgery in Egypt.

BACKGROUND: Gastric restrictive procedures such as vertical banded gastroplasty (VBG), Roux-en-Y gastric bypass (RYGB) and gastric banding have become the standard in morbid obesity surgery. Surgeons have started to perform these procedures through the laparoscope to give the patient the advantages of smaller incisions, less postoperative pain, shorter hospital stay, and earlier return to work. These laparoscopic procedures have not gained popularity in Egypt because they are more expensive and require longer operating times than open surgery. Instead, we have refined our open surgery technique into a method that gives most of the laparoscopic advantages and yet retains all of the open surgery advantages, i.e., performance of the open procedure through a 7- to 8-cm incision. METHODS: From September 1997 to July 1999, 25 morbidly obese patients underwent gastric restrictive procedures through mini-incisions with a follow-up period of < or =22 months. Twenty-one patients underwent VBG, and 4 patients underwent RYGB. Ninety-two percent of these patients were female, with a mean age of 28.8 years, a mean weight of 117 kg, and a mean body mass index of 45.7 kg/m2. RESULTS: The operative time was a mean of 56 minutes for the gastroplasty group and a mean of 116 minutes for the bypass group. The mean hospital stay was 3.3 days. Patients returned to normal activity within 15.6 days. Wound infections developed in 3 patients (12%) and incisional hernias in 2 (8%). The total expense of the procedure was one-third to one-half that of the laparoscopic procedure. CONCLUSION: If cost prevents the wide use of laparoscopic procedures for morbid obesity, performing open procedures through a miniincision is an alternative approach.

Adult↗