Ramon Vilallonga1,2, Refik Bademci3, Renato Roriz-Silva4, Sergi Sanchez-Cordero5, Yuhamy Curbelo6, Ariel Almanza7. 1. QUIROBES, Integral Obesity Care, Centro Médico Teknon, C. Marquesa de Vilallonga, 12, 08017, Barcelona, Spain. vilallongapuy@hotmail.com. 2. Endocrine, Metabolic and Bariatric Unit, General Surgery Department, Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, Center of Excellence for the EAC-BC, Barcelona, Spain. vilallongapuy@hotmail.com. 3. Camlica Hospital, Istanbul Medipol University, 34767, Istanbul, Turkey. 4. Department of Medicine, Division of General Surgery, Hospital de Base of Porto Velho, Federal University of Rondônia - Unir, Porto Velho, RO, Brazil. 5. General Surgery Department, Consorci Sanitari de l'Anoia, Barcelona, Spain. 6. General Surgery Department, Hospital Universitari de Vic (Consorci Hospitalari de Vic), Vic, Spain. 7. QUIROBES, Integral Obesity Care, Centro Médico Teknon, C. Marquesa de Vilallonga, 12, 08017, Barcelona, Spain.
Abstract
PURPOSE: The AspireAssist System® (Aspire Bariatrics, Inc. King of Prussia, PA) is a new endoscopic procedure used to treat obese patients. The aim of this dedicated video is to present a case that required revision surgery due to failure of the AspireAssist System®, and to show how the cannula was removed from the abdomen, and why sleeve gastrectomy (SG) was a good option for revisional surgery in that patient. We aim to discuss technical aspects. PATIENT AND METHODS: A 43-year-old female patient who underwent a placement in 2016. Her initial BMI (body mass index) was 38 kg/m2, with a follow-up period of 26 months. A revisional surgery was performed including dissection of the previous gastric fistula and adhesiolysis from the previous AspireAssist System® placement. A complete dissection of the gastrostomy, including removal of all the system, was done. A decision was made, once the incisura angularis and the placement of a 40 Fch bougie showed that the transection could be performed. SG was done. Patients showed an uneventful postoperative course and 4 months follow-up with 45% EWL. CONCLUSION: In case of having the device in place, the surgeon must be aware to remove intraoperatively or endoscopically, the device. Surgeons should consider endoscopic removal of the AspireAssist System® before conversion to another procedure (SG or GBP) at least 6 months of the removal. Removal of the AspireAssist System® should be performed endoscopically but direct conversion to another bariatric procedure can be considered, either to SG or GBP depending on the technical intraoperative aspects.
PURPOSE: The AspireAssist System® (Aspire Bariatrics, Inc. King of Prussia, PA) is a new endoscopic procedure used to treat obesepatients. The aim of this dedicated video is to present a case that required revision surgery due to failure of the AspireAssist System®, and to show how the cannula was removed from the abdomen, and why sleeve gastrectomy (SG) was a good option for revisional surgery in that patient. We aim to discuss technical aspects. PATIENT AND METHODS: A 43-year-old female patient who underwent a placement in 2016. Her initial BMI (body mass index) was 38 kg/m2, with a follow-up period of 26 months. A revisional surgery was performed including dissection of the previous gastric fistula and adhesiolysis from the previous AspireAssist System® placement. A complete dissection of the gastrostomy, including removal of all the system, was done. A decision was made, once the incisura angularis and the placement of a 40 Fch bougie showed that the transection could be performed. SG was done. Patients showed an uneventful postoperative course and 4 months follow-up with 45% EWL. CONCLUSION: In case of having the device in place, the surgeon must be aware to remove intraoperatively or endoscopically, the device. Surgeons should consider endoscopic removal of the AspireAssist System® before conversion to another procedure (SG or GBP) at least 6 months of the removal. Removal of the AspireAssist System® should be performed endoscopically but direct conversion to another bariatric procedure can be considered, either to SG or GBP depending on the technical intraoperative aspects.
Authors: Christopher C Thompson; Barham K Abu Dayyeh; Robert Kushner; Shelby Sullivan; Alan B Schorr; Anastassia Amaro; Caroline M Apovian; Terrence Fullum; Amir Zarrinpar; Michael D Jensen; Adam C Stein; Steven Edmundowicz; Michel Kahaleh; Marvin Ryou; J Matthew Bohning; Gregory Ginsberg; Christopher Huang; Daniel D Tran; Joseph P Glaser; John A Martin; David L Jaffe; Francis A Farraye; Samuel B Ho; Nitin Kumar; Donna Harakal; Meredith Young; Catherine E Thomas; Alpana P Shukla; Michele B Ryan; Miki Haas; Heidi Goldsmith; Jennifer McCrea; Louis J Aronne Journal: Am J Gastroenterol Date: 2016-12-06 Impact factor: 10.864
Authors: Max Nyström; Evzen Machytka; Erik Norén; Pier Alberto Testoni; Ignace Janssen; Jesus Turró Homedes; Jorge Carlos Espinos Perez; Roman Turro Arau Journal: Obes Surg Date: 2018-07 Impact factor: 4.129