By Henry Buchwald MD PhD
Buchwald's Atlas of Metabolic & Bariatric Surgical concepts and tactics, by means of best authority Henry Buchwald, MD, PhD, is the 1st pictorial atlas that demonstrates modern complete variety of open and laparoscopic bariatric techniques, in addition to concurrent surgical procedures comparable to hernia fix and tubal ligation. countless numbers of top quality photos and illustrations enable you to in achieving the simplest results and deal with any problems that can come up. you can find insurance of such scorching new methods as laparoscopic electrode placement, replacement open electrode placement, laparoscopic vagal pacing, and replacement open vagal pacing. At www.expertconsult.com you could reference the total textual content and illustrations from any computing device or cellular equipment. See tips to practice state-of-the-art complete variety of open and laparoscopic innovations, in addition to concurrent surgical procedures equivalent to hernia fix and tubal ligation, via viewing hundreds and hundreds of step by step images and illustrations. grasp scorching new strategies corresponding to laparoscopic electrode placement, substitute open electrode placement, laparoscopic vagal pacing, and substitute open vagal pacing. receive the simplest effects and steer clear of problems with specialist tips and proposals from Dr. Henry Buchwald, who has chaired or presided over the Surgical Council of the yankee university of foodstuff, the crucial Surgical organization, the yank Society for Bariatric surgical procedure, and different major enterprises. Reference the full textual content and illustrations from any machine or cellular machine at www.expertconsult.com. grasp all kinds of bariatric surgical procedures, in addition to concurrent and revisional surgical procedures with step by step visible information.
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Additional resources for Buchwald's Atlas of Metabolic & Bariatric Surgical Techniques and Procedures: Expert Consult - Online and Print
5-mm staples (blue load). Thus, the bowel division is 300 cm from the ileocecal valve (a 50-cm common channel and a 250-cm Roux limb). The jejunal mesentery is divided for a distance of 4 to 6 cm to allow mobility of the cut ends. The mesenteric division is created with the cutting linear stapler. s The divided stapled jejunal ends, representing the proximal end of the Roux limb and the distal end of the biliopancreatic limb, may be oversewn with interrupted or running, 2/0, nonabsorbable sutures.
Some surgeons prefer to oversew both the entire anterior staple line and the entire posterior staple line. s Anastomotic closure with interrupted sutures. ◆ Chapter 3 • Biliopancreatic Diversion 49 Figure 3-28 Figure 3-29 50 Section II • Primarily Malabsorptive Procedures Figure 3-30: The mesenteric defect created by the jejunoileostomy must be carefully closed to prevent an internal hernia. ◆ Figure 3-31: Attention is now turned to the upper abdominal portions of the procedure. The patient is placed in the reverse Trendelenburg position, and the liver is elevated with the laparoscopic liver retractor.
12 The jejunoileal bypass was a highly effective weight-reduction operation but was associated with gasbloat syndrome, steatorrhea, electrolyte imbalance, nephrolithiasis, hepatic fibrosis, cutaneous eruptions, and impaired mentation. 2 Malabsorptive procedures did not become extinct, only dormant; they reemerged in the 1970s and became prevalent globally in the 1990s. The newer, primarily malabsorptive procedures, which are currently popular, circumvented most of the complications of the jejunoileal bypass by eliminating stasis in the bypassed intestinal segment, which had allowed bacterial overgrowth, predominantly of anaerobic bacteria, causing secondary intestinal complications and systemic toxicity.
Buchwald's Atlas of Metabolic & Bariatric Surgical Techniques and Procedures: Expert Consult - Online and Print by Henry Buchwald MD PhD