1,723,406 research outputs found
Silver Linings 2024
Full text linkhttps://scholarcommons.towerhealth.org/silver_linings/1002/thumbnail.jp
Silver Linings 2025
No full texthttps://scholarcommons.towerhealth.org/silver_linings/1004/thumbnail.jp
6R9LP75LMP Increasing Access to Metabolic and Bariatric Surgery Programs for Adolescents
No full textLisa Baro Tower Health; Vesta Salehi Tower Health/Drexel University; Renee Riddle Tower Health; John Fam; Aaron Hechtman Tower Health; Stephan Myers Tower Health / Drexel University Introduction: [A robust adolescent metabolic and bariatric surgery (MBS) program was developed at The Reading Hospital. Adolescents are referred following the development of two of the largest multidisciplinary pediatric and adolescent weight management programs in the Commonwealth of Pennsylvania: (1) The Reading Hospital Weight Loss Surgery and Wellness Center in Wyomissing, Pa and (2) St. Christopher’s Hospital for Children Healthy Kids, Healthy Teens Program in Philadelphia. This arrangement brings a diverse adolescent population to our surgical practice.] Method: [We reviewed the MBSAQIP Registry Data on 126 MBS operations performed at Reading Hospital between August 20, 2020 and December 31, 2024 on adolescents age 15 to 19. All procedures were performed laparoscopically and included 124 gastric sleeves, 1 gastric bypass, and 1 conversion from a gastric sleeve to a single anastomosis duodenal switch. Data collected included demographics including race, weight loss, change in BMI, co-morbid conditions, surgical complications.] Results: [Review of our data has shown dramatic results with an average weight loss of 100 pounds and a decrease in BMI of 16 at one year following surgery. This was a diverse population including 58% Hispanic, 19% Black, and 15% White. Resolution: diabetes 93.3%, hypertension 91% and obstructive sleep apnea 95%. There was no mortality, leaks, transfusions or return to the operating room. Three patients required hydration, 3 were seen in the ED for abdominal pain or minor incisional bleeding and discharged and 2 were admitted for vitamin B1 deficiency. ] Conclusion: [Building new multidisciplinary pediatric and adolescent weight management programs is an effective strategy to increase access to MBS in adolescents. MBS is safe and effective in a diverse population
Acquired von Willebrand syndrome: A rare presentation of Waldenstrom Macroglobulinemia – Reading Hospital, Tower Health System
No full textVD5K58YKDZ Association Between Weight Lost and Diabetes Resolution After Bariatric Surgery With Preoperative GLP-1 Agonist Use
No full textEllen Pekar University of Pennsylvania; John Fam Tower Health/Drexel University; Roshan Shaik Tower Health Introduction: GLP1 agonists have rapidly emerged as effective tools for management of obesity and obesity related complications. With the shared mechanism between bariatric surgery and GLP-1 agonists, it would lead to reason that a combination approach between surgery and medical management would lead to increased postoperative weight loss in the long term. This study will aim to evaluate if there is a benefit postoperatively from preoperative GLP-1 use in bariatric surgery patients. Method: Retrospective study looking at all patients from a single bariatric center undergoing primary bariatric surgery (sleeve, SADI, RYGB) from 2021- July 2024. Data on BMI at different time points pre/postoperatively, medication use from time of program until weight loss surgery, type of bariatric surgery performed, diabetes status, A1c pre and post op, complications, and readmissions was collected. Results: Preliminary results were collected from 60 patients. 30 (50%) patients received a GLP-1 agonist preoperatively for at least 6 weeks. For the GLP1 group there was a 11.5 ± 14.7 BMI change at 6 months postoperatively vs a 12.6 ± 17.3 change in the control group (p=.28). There was no statistically significant BMI reduction between groups. There was no difference in perioperative complications between groups (p=0.36). There was no statistically significant rate of diabetes resolution between groups (p=1.59). Conclusion: From preliminary results there is no additional postoperative benefit in regards to weight loss or diabetes resolution from addition of GLP1 agonist preoperatively. Further analysis will be done on the data in order to increase sample size and accuracy. Further studies are required in order to evaluate the long term effects of GLP-1 agonists on bariatric surgery patients
QMVAPJDAWL Performance of A Robotic Assisted Laparoscopic Gastro-Gastric Fistula Takedown
No full textEllen Pekar University of Pennsylvania; John Fam Tower Health/Drexel University Introduction: A 65 yo female with history of open roux-en-y gastric bypass in 2005 presented with chronic epigastric pain. The patient reported a history of chronic marginal ulcers and was on BID dosing of her PPI with continued symptoms. Method: EGD performed showing healing marginal ulcers and a 5 mm gastro-gastric fistula. Preoperative CT scan obtained confirming diagnosis. Decision was made to undergo G-G fistula takedown. Access obtained in the supraumbilical position with a 5mm Optiview trocar. 12 mm port placed to the right of the umbilicus. 8 mm port placed in the right lateral abdomen. Two 8 mm ports placed in the left side of the abdomen. 5mm port upsized to 8 mm port. Extensive adhesiolysis performed taking down adhesions from pouch, liver, and gastrojejunostomy to surrounding structures. EGD performed confirming anatomy. Roux limb divided distal to gastrojejunostomy using white load on a sureform stapler. Short gastric vessels ligated. Gastric remnant transected at antrum using two blue loads. Pouch transected proximal to gatrojejunostomy using a blue load. Two layer handsewn anastomosis with 2-0 stratafix created between roux limb and gastric pouch. Leak test negative. Gastric remnant removed. Results: Patient doing well postoperatively with resolution of epigastric pain 41 days after surgery. Conclusion: A robotic laparoscopic revision with excision of gastrojejunostomy, partial gastrectomy, and takedown of gastro-gastric fistula is an effective method for dealing with gastro-gastric fistula after previous Roux-en-y gastric bypass
R9Q7AZG796 Performance of A Robotic Assisted Laparoscopic Sleeve Gastrectomy in a Patient With Prior Open Loop Duodenojejunostomy for Duodenal Atresia
No full textEllen Pekar University of Pennsylvania; John Fam Tower Health/Drexel University Introduction: A 45 yo female with a history of duodenal atresia repair presented to the bariatric surgery service with a BMI of 47.44. The patient previously underwent an aborted laparoscopic sleeve gastrectomy at an outside hospital. Method: Preoperative EGD obtained. Loop configuration noted in the first portion of the duodenum with two lumens leading into segments of small bowel. UGI obtained confirming a loop configuration. Decision was made to undergo sleeve gastrectomy. Access obtained in the RUQ with 5mm Optiview trocar. Two 8 mm ports placed in the left lateral abdomen. 12 mm port placed supraumbilically. 8 mm port placed in the right lateral abdomen. Extensive adhesiolysis performed taking down gastric, hepatic, and omental adhesions. Liver retracted with a Stratafix. 5 cm from pylorus measured out. Short gastric vessels ligated with a Harmonic. Moderate sized hiatal hernia primarily repaired. •0 Fr Visi G tube placed. Sleeve created with firing of one blue load and several white loads on a Sureform stapler. Results: Patient doing well postoperatively with 26 lb weight loss 2 weeks after surgery. A month out from surgery she continues to do well. Conclusion: It is safe and feasible to perform a robotic laparoscopic sleeve gastrectomy in a patient with prior open loop duodenojejunostomy
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