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Surgical Treatments of Obesity
Published in Ruth Chambers, Paula Stather, Tackling Obesity and Overweight Matters in Health and Social Care, 2022
Intra-gastric balloon: this is an excellent non-operative, reversible modality to aid short-term weight loss and is also offered as a prelude for some major procedures. This operation is performed as a day case procedure under sedation or general anaesthetic. Initially a gastroscopy is performed to check the oesophagus, stomach and duodenum, and then a balloon is passed trans-orally and inflated with saline under endoscopic guidance, up to a capacity of 400 to 600 mls. The balloon usually moves to the fundus of the stomach and appears to induce an artificial satiety, resulting in an average weight loss of 10–20 kgs. These balloons have to be removed endoscopically after a time period of six months to one year. Unless lifestyle changes are implemented, the majority of patients regain their lost weight.
The liver
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
If the rate of blood loss prohibits endoscopic evaluation, a Sengstaken-Blakemore tube may be inserted to provide temporary haemostasis (Figure65.13). Once inserted, the gastric balloon is inflated with 300 mL of air and retracted to the gastric fundus, where the varices at the oesophagogas- tric junction are tamponaded by the subsequent inflation of the oesophageal balloon to a pressure of 40 mmHg. The two remaining channels allow gastric and oesophageal aspiration. The position of the tube is confirmed radiologically. The balloons should be temporarily deflated after 12 hours to prevent pressure necrosis of the oesophagus. Aspiration pneumonia and oesophageal ulceration are other complications. Balloon tamponade is very effective in stopping bleeding and once the patient is stabilised, a more definitive treatment can be carried out.
Weight loss surgery: the facts and figures
Published in Jenny Radcliffe, Cut Down to Size, 2013
Randomised controlled trials with intragastric balloon have not shown conclusively that it produces better weight loss than a standard approach to weight management29 and most people will regain the weight they lost with the gastric balloon if they do not have further weight loss surgery.28 The gastric balloon is intended as a short-term intervention and within the NHS is mainly used to get you down to a weight where you can have a permanent bariatric procedure with less risk.
In vitro evaluation of enteral tube administration of lansoprazole orally disintegrating tablets
Published in Pharmaceutical Development and Technology, 2021
Alicia Hoover, Priyanka Chitranshi, Magdalene Momot, Katherine Tyner, Anna Wokovich
Even though lansoprazole is only labeled for NG tube administration, there have been reports of off-label G and J tube administration. A feature of some G and J tubes is the gastric balloon that is inflated with water to hold the tube in place (McClave and Neff 2006). Three of the four G and J tubes used in this study contained a gastric balloon (shown in Figure 1(C,D,F)). The gastric balloons were filled with deionized water to the recommended fill volume (as described in Table 1) before lansoprazole delivery. J tube 3 (shown in Figure 1(E)) does not have a gastric balloon but is intended to be inserted through a PEG (percutaneous endoscopic gastrostomy) tube. PEG tubes are widely used because the placement procedure is minimally invasive and can help reduce cost and patient discomfort (Williams 2008; Blumenstein et al. 2014; Lucendo and Friginal-Ruiz 2014). The G and J tubes described in Table 1 were selected to determine if the length and design of the tube impacted lansoprazole delivery.
The Effect of Noninvasive Bariatric Surgery on the Levels of Certain Adipokines and Atherosclerosis Risk Factors in Patients with Metabolic Syndrome
Published in Journal of the American College of Nutrition, 2020
Agnieszka Wojciechowska-Kulik, Edyta Blus, Zbigniew Kowalczyk, Zbigniew Baj, Ewa Majewska
Weight reduction following the implantation of gastric balloon occurs as an effect of limiting food intake due to reduced stomach volume and delayed gastric emptying. A key role is also played by centrally-caused satiety resulting from the stomach walls being stretched, which stimulates the vagus nerve receptors and brain centers responsible for satiety, as well as changes in the activity of gastrointestinal hormones and neuropeptides, which affects appetite control (32). Weight loss resulting from a reduction in the total amount of calories consumed results in the modification in the expression of adipogenic genes such as the PPAR receptor (Peroxisome proliferator-activated receptor) gene (33). Miyazaki et al. report that PPAR receptor agonists promote the transformation of preadipocytes into better functioning adipocytes in visceral and subcutaneous fat deposits (34) and promote the apoptosis of hypertrophic and dysfunctional adipocytes. This mechanism may play an essential role in improving metabolic processes in fat-related diseases like MetS. Another likely mechanism for the positive metabolic effect of a low-calorie diet includes its effects on the cannabioid receptor (CB)-1. Decreased adipogenesis associated with hypocaloric diets occurs as a result of the decreased appetite promoted by CB-1 receptor antagonists. Blocking the CB-1 receptor improves fat functions which is reflected in the improvement of glucose, TG, HDL and LDL metabolism (35).
Usefulness of New Indicators of Obesity (BAI and VAI) in Estimation of Weight Reduction
Published in Journal of the American College of Nutrition, 2020
Edyta Blus, Agnieszka Wojciechowska-Kulik, Ewa Majewska, Zbigniew Baj
The presented results show that despite the significant loss of body weight and percentage of fat tissue after the implantation of the gastric balloon, the WHR value did not significantly decrease, while a significant decrease in the WHtR index was observed. The percentage loss of the WHtR index value correlated positively with the percentage decrease in the value of all the anthropometric indicators tested. The results of the presented studies and literature data indicate that the WHR index is not always useful in determining the type and degree of obesity and its reduction. In the group of 164 teenagers examined by Konstantynowicz et al., the waist circumference value better than WHR correlated with the arm circumference, thickness of skin folds, and percentage of adipose tissue. According to these authors, the measurement of hip circumference and WHR calculation are not useful anthropometric parameters (22). However, without a precise measure of visceral obesity, the index of abdominal obesity cannot be clearly characterized and defined.