by James N. Lau, MD, FACS; and Myriam J. Curet, MD, FACS Both are with Stanford School of Medicine, Stanford University

INTRODUCTION

Obesity is a well recognized public health epidemic affecting not only the United States, but the world. “This insidious, creeping pandemic of obesity is now engulfing the entire world,” Australia’s Monash University professor Paul Zimmet, Chair of the 10th International Congress on Obesity, said on the opening day of the conference. Mounting evidence now rates obesity, with its multiple comorbid diseases, as the second most preventable cause of death next to smoking in the US.

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by Stephanie B. Jones, MD; Jeffrey M. Ellenbogen, MD; and Daniel B. Jones, MD, FACS

Obstructive sleep apnea (OSA) is a medical condition that leads to significant morbidity and reduced quality of life.

INTRODUCTION

Obstructive sleep apnea (OSA) is a medical condition that leads to significant morbidity and reduced quality of life. Patients with OSA are particularly vulnerable to certain perioperative complications, and the incidence of OSA in the bariatric population may be as high as 77 percent.1 Therefore, the surgeon and bariatric team should routinely screen for OSA as part of the preoperative workup. In this article, we will provide a brief overview of OSA, focusing primarily on the challenges that face surgeons and anesthesiologists in handling these cases. By understanding this disorder, and how it is perturbed in the perioperative period, surgical outcomes may be considerably improved.

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by Louis O. Jeansonne IV, MD; Craig B. Morgenthal, MD; Brent C. White, MD; and Edward Lin, DO

All from Emory Endosurgery Unit, Emory University School of Medicine

Laparoscopic Roux-en-Y gastric bypass (LGBP) has been shown to be an effective treatment for morbid obesity, both in terms of weight loss and improvement in multiple comorbidities. 1 While the laparoscopic approach offers many advantages to the patient in terms of fewer wound complications, decreased length of hospital stay, and decreased postoperative pain, certain complications of this operation continue to pose difficult clinical problems as the number of procedures performed increases. One such complication is internal hernia through one of the mesenteric defects, which can result in small bowel obstruction, ischemia, or infarction and often requires reoperation.
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