Vertical ring gastroplasty (VRG) in the treatment of the serious clinical obesity. Results and complications.

OBJECTIVE: The morbid obesity is a serious polysystematic disease to which it is necessary to offer a surgical solution when the conservative alternatives fail. METHODS: In a period of five years, 50 patients with vertical ring gastroplasty (VRG) have been evaluated and protocolized in the program of surgery of the morbid obesity, with an average weight of 134.3 kg corresponding to an overweight and body mass index (BMI) average respectively, of 69.7 kg and 49.8 kg/m2. RESULTS: The early morbidity has been scarce and the postoperative average stay of 7 days. The decrease of the percentage of weight, overweight and BMI was maximum 2 years later, with losses of 52 kg, with a percentage of loss of average overweight of 76.8% and a fall of 21 points in the BMI; however there was a partial recovery of the indexes in the following years. The accompanying pathology was solved in the period of studied time, although 84% of the patients referred vomits and practically 100% dietary limitations. CONCLUSIONS: The gastroplasty is a quick, simple technique and of scare morbimortality, although it is being subjected to criticism for the restrictions in the diet, quality of life and disruptions of the line of clamped. However, nowadays there is not a consensus on the ideal bariatric solution, and as a surgical alternative, the vertical gastroplasty can represent one of the techniques of choice for certain selected types of serious obesity.

Intragastric migration of laparoscopic adjustable gastric band (Lap-Band) for morbid obesity.

The appearance of fistulas and the posterior intragastric inclusion of the adjustable silicone Lap-Band prothesis have been described, representing a severe complication of the Lap-Band procedure. A 45-year-old patient with severe obesity, weighing 115 kg, and having BMI (body max index) of 45 kg/m2 was assigned to a protocol to place a Lab-Band in her. An infection in the reservoir after 9 months indicated the beginning of the appearance of fistulas. The entire adjustable silicone gastric band device eroded inside the stomach between months 9 and 14 after its placement, resulting in reoperation. The gastric inclusion of the Lap-Band device represents a severe complication that requires reoperation, and raises concerns about the safety of this new alternative weight reduction operation.

[Bladder leiomyoma: a new case for the current caseload]. / Leiomioma vesical: un nuevo caso a la casuística existente.

Vesical leiomyoma is a benign mesenchymal tumor that rarely involves the bladder and makes about 1.5% of all vesical tumors. A new case is presented and aspects concerning clinical, diagnostic and surgical issues are examined. The paper includes a revision of the available literature on the topic.