Single incisional laparoscopic sleeve gastrectomy (SILSG) has been proposed as an alternative approach to the conventional multiport laparoscopic procedure. However, there has been no reported SILSG case in Korea, even though single incisional laparoscopic distal gastrectomy for early gastric cancer has increasingly reported in Korea and Japan. We recently performed 5 cases of SILSG for morbidly obese Korean patients, one of whom was 14-year-old adolescent female patient. Here, we describe our technical strategy for SILSG and present a brief review of literature about adolescent bariatric surgery.
Adolescent* ; Bariatric Surgery* ; Female ; Gastrectomy* ; Humans ; Japan ; Korea ; Stomach Neoplasms

High blood pressure is a serious health problem and a primary risk factor for both stroke and heart disease. Many studies have strongly assessed short-term effects as well as long-term effects of bariatric surgery on type2 diabetes mellitus, whereas little attention has been paid to the effect on hypertension. This review study was designed to evaluate the impact of Bariatric Surgery and weight loss on obese patients with hypertension, and whether the hypertension improved or resolved post-surgery. Relevant papers were searched using MEDLINE, Science Citation Index, Pub Med, and Clinical Evidence, by using the searched terms (Hypertension, Bariatric, Obesity, and Surgery). The association between weight reduction and Hypertension control is hard to analyze. And well-organized studies with a long term follow up are required to determine the effect of Bariatric Surgery and Hypertension control.
Bariatric Surgery* ; Diabetes Mellitus ; Follow-Up Studies ; Heart Diseases ; Humans ; Hypertension* ; Obesity ; Risk Factors ; Stroke ; Weight Loss

Advances in genomic processing technology have been applied to the human microbiota and have provided the understanding of the effect of the microbiota in human health and disease. Especially, studies of the gut microbiota have revealed that changes in gut microbiota are related to obesity and the metabolic syndrome. With weight gain, there is an increase in the ratio of Firmicutes to Bacteroidetes. Certain bacteria have increased the ability to ferment dietary substrates, thereby increasing hosts' energy intake and weight gain. After transplantation of microbiota from lean donors, insulin sensitivity of recipients increased along with proliferation of butyrate-producing intestinal microbiota. One important finding after Roux-en-Y gastric bypass is the relative overabundance of Proteobacteria, which is different with the changes seen in weight loss without bypass surgery. Due to the change of microbiota's composition after bypass surgery, the gut environment is changed to unfavorable for energy absorption including decrease of polysaccharide fermentation. Therefore this change may contribute to the improvement of insulin resistance and loss of body weight. According to these results, modifying the gut microbiota through diet, probiotics, fecal transplants, and surgery might be included as therapeutic options for the diseases linked to imbalance in the microbiota.
Absorption ; Bacteria ; Bacteroidetes ; Bariatric Surgery ; Body Weight ; Diabetes Mellitus ; Diet ; Energy Intake ; Fermentation ; Gastric Bypass ; Humans ; Insulin Resistance ; Microbiota* ; Obesity ; Probiotics ; Proteobacteria ; Tissue Donors ; Weight Gain ; Weight Loss

The prevalence of morbid obesity is rising progressively among elderly patients in the world. The incidence of obesity in Koreans, 60 years and older was 34.2% in 2012. Although there was no consensus on criteria for weight loss management in aged persons, it is clear that weight loss therapy improves metabolic syndrome, physical function and health-related quality of life in obese older persons. The current therapeutic tools available for weight management in older persons do not differ from those for weight management in general; 1) lifestyle intervention involving diet, physical activity, and behavior modification; 2) pharmacotherapy; and 3) surgery. Currently, bariatric surgery can be safely performed with low morbidity and mortality rates in obese older people. In addition, the elderly can lose clinically significant amounts of weight after bariatric surgery and significant weight reduction is associated with an improvement in obesity-related co-morbidities and an overall reduction in medication requirements. Patient selection for bariatric surgery should not be based on age alone.
Aged* ; Bariatric Surgery* ; Behavior Therapy ; Consensus ; Diet ; Drug Therapy ; Humans ; Incidence ; Life Style ; Mortality ; Motor Activity ; Obesity* ; Obesity, Morbid ; Patient Selection ; Prevalence ; Quality of Life ; Weight Loss

Body weight and body mass index (BMI) to be simply measured and analyzed are most common methods to assess the effect of bariatric surgery. In addition, measurement of subcutaneous and visceral adipose tissues by imaging technique has been adapted as a kind of anthropometrics. After bariatric surgery, obese patients with metabolic disorder are tested by conventional parameters such as fasting blood glucose, blood lipid panel, insulin level and blood pressure. Recently, the adipokines associated with inflammation, such as high-sensitive C-reactive protein and adiponectin, are accepted as new measure of follow-up examination. In this review, various measurement parameters, from anthropometrics to cytokine, to assess the effect of bariatric surgery are introduced, so that bariatric surgeons could keep in mind its significance in Korea where bariatric surgery is still unpopular.
Adipokines ; Adiponectin ; Bariatric Surgery* ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Body Weight ; C-Reactive Protein ; Fasting ; Follow-Up Studies ; Humans ; Inflammation ; Insulin ; Korea

Esophageal and gastric pouch dilatations are common complications that occur after laparoscopic adjustable gastric banding, often performed to treat morbid obesity. Most cases are treated by a gastric band deflation or a removal of band. Nevertheless, additional surgical procedures are rarely ever needed to treat persistent dysphagia and pouch dilatation. We report here, the case of a 38-year-old woman with constant vomiting and severe persistent epigastric pain despite the gastric band deflation, and a band scar stenosis, treated via laparoscopic conversion sleeve gastrectomy. Surgical band scar revision, or revision sleeve gastrectomy, may be considered if gastric pouch dilation and dysphagia are not treated by gastric band deflation.
Adult ; Cicatrix* ; Constriction, Pathologic* ; Deglutition Disorders ; Dilatation* ; Esophagitis, Peptic ; Female ; Gastrectomy* ; Humans ; Obesity, Morbid ; Vomiting

PURPOSE: Laparoscopic greater curvature plication (LGCP) is the new emerging surgical technique for treating morbid obesity. The short-term results of LGCP are not yet available in Korea. MATERIALS AND METHODS: We retrospectively reviewed prospectively collected 18 patients' data with over 30 kg/m2 body mass index (BMI) who underwent LGCP from January 2013 to October 2014. Fifteen of these patients who had more than 3 months of follow-up were included in this report. LGCP was performed laparoscopically using interrupted and continuous sero-muscular suture from fundus to antrum over a 36-French bougie. RESULTS: Mean age at the time of surgery was 33.1+/-7.9 years in our patients. Mean weight was 98.9+/-15.5 kg and mean BMI was 35.7+/-4.1 kg/m2 preoperatively. The percentage of excess BMI loss (%EBL) in the postoperative first, third and sixth month was 33.6+/-9.1, 51.6+/-15.4 and 64.5+/-18.3%, respectively. There were no 30-day peri-operative mortality and major complications including bleeding, leakage and conversion bariatric surgery. CONCLUSION: These findings show that LGCP is a safe and effective weight loss option for morbidly obese Korean patients in short-term period. Randomized prospective control studies between gastric banding or sleeve gastrectomy and LGCP, are needed to confirm short-term weight loss effect and safety of LGCP in this group of patients.
Bariatric Surgery ; Body Mass Index ; Follow-Up Studies ; Gastrectomy ; Hemorrhage ; Humans ; Korea ; Mortality ; Obesity, Morbid ; Prospective Studies ; Retrospective Studies ; Sutures ; Weight Loss

PURPOSE: Sleeve gastrectomy (SG) is an emerging approach, but there have been a surge in popularity because of its perceived technical simplicity, feasibility, and good outcomes. We describe results of a single fully experienced gastric surgeon's short-term outcomes of laparoscopic sleeve gastrectomy (LSG) and robotic sleeve gastrectomy (RSG) for morbidly obese patients. MATERIALS AND METHODS: We retrospectively reviewed 20 patients underwent LSG and RSG from July 2010 to February 2014. RESULTS: The mean age was 36.3+/-10.1 years, the mean preoperative body mass index (BMI) was 37.3+/-5.4 kg/m2. Mean operative time was 124.4+/-36.2 min. The postoperative length of stay was 5.1+/-4.1 day. There was no open conversion and mortality, nor severe postoperative complication found in the LSG and RSG cases. The mean BMI decreased to 26.1+/-2.5 kg/m2 at 1 year and the mean percentage excess weight loss was 69.8+/-24.9% at 1 year. CONCLUSION: Effective weight loss without complication would be achieved by sleeve gastrectomy if the procedure is performed by experienced gastric surgeon. However, further well-designed comparative studies with larger sample size are warranted to prove this preliminary result.
Body Mass Index ; Gastrectomy* ; Humans ; Laparoscopy ; Length of Stay ; Mortality ; Obesity, Morbid ; Operative Time ; Postoperative Complications ; Retrospective Studies ; Sample Size ; Weight Loss

As the epidemic of morbid obesity has been rising globally over the decade, bariatric surgery has also been grown to manage obesity and its comorbidities. Besides of its safety, laparoscopic adjustable gastric banding (LAGB) has been known to be more effective in handling obesity with regard to weight loss and its long-term sustainability, compared to medical treatments. Failure of LAGB, defined as either the unsatisfactory weight loss or the development of major long-term complications, results in revision or removal of gastric band. After explantation of gastric band, rebanding or conversion into other bariatric surgeries such as Roux-en-Y gastric bypass or sleeve gastrectomy is required in terms of maintaining weight loss. Major cause of band removal alone is psychogenic factors like patients' anxiety or feeing discomfort without anatomic problems. In Korea there has been grown of patients' vague demand to remove their gastric band regarding the death of a celebrity. Considering such trend, in order to prevent indiscriminate finish of the treatment, suggestion of appropriate time for gastric band removal on the basis of analyzing the course of weight loss and the occurrence of complications is essential.
Anxiety ; Bariatric Surgery ; Comorbidity ; Fees and Charges ; Gastrectomy ; Gastric Bypass ; Korea ; Obesity ; Obesity, Morbid ; Weight Loss

Laparoscopic sleeve gastrectomy is one of the most popular procedure for the treatment of morbid obesity. Postoperative bronchogastric fistula is very rare and difficult to manage. This complication requires multiple radiological, endoscopic, and surgical procedures. We report here the case of a 28 years old foreign woman who underwent laparoscopic sleeve gastrectomy for morbid obesity in her contury. She complained of a cough with fever and was diagnosed a postoperative bronchogastric fistula. After failure of conservative treatment, she wanted to treat at our hospital. First of all, we inserted a stent for the fistula, however, it failed to treatment. And then, we performed a thoracoscopic segmentectomy and laparoscopic proximal gastrectomy with double tract reconstruction.
Cough ; Female ; Fever ; Fistula* ; Gastrectomy* ; Humans ; Mastectomy, Segmental ; Obesity, Morbid ; Stents