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Öğe Autologous Peritoneum Graft Repair of a Superior Mesenteric Vein Defect During Pancreaticoduodenectomy(Springernature, 2015) Kayaalp, Cuneyt; Sumer, Fatih; Polat, Yilmaz; Kutlu, RamazanPancreatic cancers frequently invade the portomesenteric veins. Venous resection during pancreaticoduodenectomy with curative intent is more common now than it was in the past. Most venous resections can be repaired primarily, but some require vascular grafts. Here, we describe the use of an autologous parietal peritoneum graft instead of vascular grafts for repairing a superior mesenteric vein (SMV) defect. Pylorus-preserving pancreaticoduodenectomy combined with en bloc resection of the SMV lateral wall was performed in a 70-year-old woman with cancer of the pancreatic head. The SMV defect was 2 cm long and its width was half the SMV circumference. The defect was covered with a 3 x 2 cm parietal autologous peritoneum graft obtained from the left subcostal area and using running 6/0 polypropylene suture. Tension-free patching was performed, and we retained slight bulging of the graft. Her postoperative course was uneventful. She was discharged on Day 11 after computed tomography confirmed the patency of the SMV, despite slight narrowing. She was well after 10 months of follow-up. Autologous parietal peritoneum grafts can be used for repairing partial venous defects during pancreaticoduodenectomy. They are effective and are easy, fast, and cheap to obtain.Öğe Can revision of RYGB to sleeve gastrectomy be a solution to inadequate weight loss treatment?(Mexican Acad Surgery, 2022) Okut, Gokalp; Turgut, Emre; Kaplan, Kuntay; Sumer, Fatih; Kayaalp, CuneytWe aimed to discuss the weight loss success of the revision of RYGB to sleeve gastrectomy (SG). Between January 2019 and June 2020, four patients' files were analyzed retrospectively. Post-RYGB mean minimal BMI was 27.4 +/- 9.47 kg/m2, be-fore SG the mean BMI was 43.41 +/- 4.16 kg/m2. Post-operative gastric fistula developed in two patients. The mean follow-up time after revision surgery was 17.25 +/- 6.89 months, mean excess weight loss (EWL) was 74.77 +/- 8.94%, and mean BMI was 32.65 +/- 2.9 kg/m2. Despite high rate of major complications, revision of RYGB to SG is successful in weight loss and resolving certain complications of RYGB.Öğe A case of Krukenberg tumor, eight years after treatment of gastric cancer(Marmara Univ, Fac Medicine, 2018) Karagul, Servet; Sumer, Fatih; Onur, Asim; Tardu, Ali; Dagli, Adile Ferda; Kayaalp, CuneytKrukenberg tumor is a rare metastatic tumor of the ovary. The primary tumors are usually gastrointestinal cancers. Most of the Krukenberg tumors reported in the literature occurred within the first 2 years after treatment of the primary disease. Herein, we present a case of Krukenberg tumor in a 37-year-old woman who previously underwent surgery and chemotherapy for stomach cancer. This patient is noteworthy because it is one of the few documented cases of ovarian metastasis appearing after a disease-free period of 8 years following treatment of the primary tumor. Krukenberg tumors are associated with poor prognosis; therefore, regular gynecological examination in female patients with history of gastric cancer is very important for the early diagnosis and treatment of this disease.Öğe A case of vaginal recurrence following laparoscopic left-sided colon cancer resection combined with transvaginal specimen extraction(Wolters Kluwer Medknow Publications, 2019) Gundogan, Ersin; Cicek, Egemen; Sumer, Fatih; Kayaalp, CuneytHere, we presented a case of laparoscopic colon cancer resection who developed vaginal recurrence after transvaginal specimen extraction. To our knowledge, this is the first case report on natural orifice specimen extraction-site cancer recurrence. A 59-year-old female underwent laparoscopic left hemicolectomy due to left-sided colon adenocarcinoma, and the specimen was removed through the vagina. She was admitted to the hospital with the complaint of vaginal discharge after 1 year. Tumoural infiltration on the posterior vaginal wall was diagnosed, and biopsy was reported as adenocarcinoma. The patient underwent laparoscopic low anterior resection, total abdominal hysterectomy, bilateral salpingooferectomy and en bloc resection of the posterior vaginal wall due to the local recurrence of colon cancer. She had no recurrence or metastasis within the 3rd year after primary tumour surgery. Recurrence at the specimen extraction site after natural orifice surgery should be considered among the complications. For this reason, incision-preserving methods should not be neglected.Öğe Case report of non-traumatic spontaneous intrahepatic bile duct rupture in an adult(Elsevier Sci Ltd, 2016) Sumer, Fatih; Kayaalp, Cuneyt; Karagul, Servet; Ertugrul, Ismail; Yagci, Mehmet Ali; Onur, AsimINTRODUCTION: Spontaneous rupture of the biliary duct, a rare condition in adults, is difficult to diagnose preoperatively and presents with acute abdominal symptoms. The treatment of this rare condition should be based on the individual's clinical status. We present peripheric biliary duct rupture (segment three) treated with external segment III drainage and postoperative endoscopic removal of the stones. PRESENTATION OF CASE: An 82-year-old male patient presented with abdominal pain and fever. An ultrasound (US) revealed a solid gall stone lesion, 3 cm in diameter, in liver segments three and four with additional intra-abdominal fluid accumulation without coexisting free air. A diagnostic laparotomy was then performed because the patient had signs of peritonitis. Exploration revealed a biliary leakage from the posterior surface of segment three. An external biliary drainage catheter was inserted to the perforated segment III duct via a 6 French (6F) feeding catheter. He was discharged after 10 days and his intracholedocal stent was removed postoperative after three months. The patient continues to be monitored. DISCUSSION: Spontaneous rupture of the intrahepatic biliary duct is a rare condition. Although occurrence is frequently reported as spontaneous, the majority of cases are related to choledocholithiasis. The role of surgical treatment in cases of spontaneous bile duct rupture is unclear. When biliary peritonitis is present, drainage of contaminated biliary fluid, T-tube drainage, closure of the biliary duct, as well as primary disease conditions, should be reviewed prior to treatment. CONCLUSION: Surgical treatment of spontaneous biliary duct rupture should be indicated only after careful consideration of the patient's clinical and comorbidity status. (C) 2016 The Authors. Published by Elsevier Ltd. on behalf of IJS Publishing Group Ltd.Öğe Changes in Melatonin, Cortisol, and Body Temperature, and the Relationship Between Endogenous Melatonin Levels and Analgesia Consumption in Patients Undergoing Bariatric Surgery(Springer, 2018) Altunkaya, Neslihan; Erdogan, Mehmet Ali; Ozgul, Ulku; Sanli, Mukadder; Ucar, Muharrem; Ozhan, Onural; Sumer, FatihBackground Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption. Methods The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m(2). Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature. Results There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods. Conclusions Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.Öğe Changes in melatonin, cortisol, and body temperature, and the relationship between endogenousmelatonin levels and analgesia consumption in patients undergoing bariatric surgery(Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Altunkaya, Neslihan; Erdogan, Mehmet Ali; Ozgul, Ulku; Sanli, Mukadder; Ucar, Muharrem; Ozhan, Onural; Sumer, Fatih; Erdogan, Selim; Colak, Cemil; Durmus, MahmutBackground Melatonin has analgesic, anti-inflammatory, sedative, and anxiolytic properties. However, the relationship between endogenous melatonin levels and postoperative analgesic requirements has not been well elucidated in patients undergoing bariatric surgery. We studied endogenous melatonin levels, cortisol levels, body temperatures, and the relationship between the level of endogenous melatonin and postoperative morphine consumption. Methods The trial was conducted among 30 patients who were scheduled for laparoscopic bariatric surgery. Their ages were between 18 and 65 years and their BMIs were above 40 kg/m(2). Secretion of melatonin, cortisol, and body temperature was monitored before the anesthetic induction, at 2 h intraoperatively, and at 2, 6, 10, (2:00 A.M.) and 24 h postoperatively. For each patient, morphine consumption was assessed at postoperative visits. The primary outcomes were to measure endogenous melatonin levels and to examine the relationship between these levels and morphine consumption. The secondary outcome was to observe the changes in cortisol and body temperature. Results There was a significant decrease in melatonin levels when preoperative melatonin levels were compared with intraoperative and all postoperative follow-up periods (p < 0.05). When the correlation between plasma melatonin levels and the postoperative morphine consumption of the patients was inspected, there was a significant correlation in all of the follow-up periods (p < 0.05). When preoperative cortisol levels were compared with intraoperative and postoperative cortisol levels, there was a significant difference in the follow-up periods, except two periods (p < 0.05). Body temperatures were similar in all measurement periods. Conclusions Endogenous melatonin secretion was significantly decreased in the intraoperative and postoperative periods. Furthermore, there was a significant inverse correlation between changes in endogenous melatonin levels and morphine consumption.Öğe Chemotherapy Related Late Enterocutaneous Fistula Following Laparoscopic Total Gastrectomy for Cancer(Gazi Univ, Fac Med, 2021) Uylas, Ufuk; Sumer, Fatih; Kayaalp, CuneytPostoperative adjuvant chemotherapy is known to be effective for survival in advanced gastric cancer. However, some severe gastrointestinal side effects during chemotherapy can interrupt adjuvant therapy. A 47-year-old woman underwent laparoscopic total gastrectomy for advanced stomach cancer (T4N2M0: Stage IIIB). Cisplatin and 5-fluorouracil chemotherapy was started postoperatively. During the third course of chemotherapy (on the postoperative 102 day) some gastrointestinal content including bile appeared through the healed laparoscopic trocar site. Computed tomography revealed a retroperitoneal abscess connected with this fistula. After percutaneous drainage of the abscess, the fistula ceased spontaneously. The patient was evaluated for chemotherapy again. Chemotherapy-induced gastrointestinal fistula can be seen postoperatively and this can interrupt the patient's chemotherapy process.Öğe Clip closure and division instead of stapling for the last small gastric bridge between gastric pouch and remnant stomach in laparoscopic Roux-en-Y gastric bypass(Elsevier Science Bv, 2017) Yuksel, Adem; Sumer, Fatih; Kayaalp, CuneytIntroduction: Here, a modification during gastric pouch forming was implemented in laparoscopic Roux-en-Y gastric bypass (LRYGB). We aimed to examine the feasibility of metallic clip closure for the remaining small stomach bridges (< 1 cm) between the pouch and the remnant stomach. Methods: During pouch creation, after the last stapler firing, the remaining small bridge was closed with clips and divided instead of using a new stapler. Metallic clips for this aim were used in 41 of 520 LRYGP between September 2010 and January 2017. Preoperative mean body mass index (BMI) was 47.3 +/- 5.3 kg/m(2) (male/female: 6/35, mean age 37.8 +/- 9.1 years). Results: Gastric bridges in 41 patients were successfully closed with metallic clips and divided. In one patient, intraoperative methylene blue test was positive from the anastomosis (not from the clipped place) and repaired by intracorporeal sutures. Abdominal drain was used selectively (32%). No postoperative leakage or other complications were seen. Mean length of hospital stay was 3.8 +/- 1.1 days. Mean BMI was 30.3 +/- 6.1 kg/m(2) after mean 17.6 +/- 11.3 months follow-up. Conclusion: In LRYGB metallic clip closure for a stomach bridge (< 1 cm) between the pouch and the remnant stomach is an easy, safe and reliable method. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.Öğe Comparison of Direct Trocar Entry and Veress Needle Entry in Laparoscopic Bariatric Surgery: Randomized Controlled Trial(Mary Ann Liebert, Inc, 2015) Ertugrul, Ismail; Kayaalp, Cuneyt; Yagci, Mehmet Ali; Sumer, Fatih; Karagul, Servet; Tolan, KeremBackground: We aimed to compare the direct trocar insertion (DTI) and Veress needle insertion (VNI) techniques in laparoscopic bariatric surgery. Materials and Methods: Eighty-one patients scheduled for bariatric surgery at Inonu University, Malatya, Turkey, were included in this study. In 39 patients, a bladed retractable nonoptical trocar was used for DTI, and VNI was performed in 42 patients. Intraoperative access-related parameters were compared. Data were analyzed with Student's t and chi-squared tests. A P value of <.05 was considered significant. Results: Both groups had comparable demographic profiles. Laparoscopic entry time was shorter in the DTI group (79.6 +/- 94.6 versus 217.6 +/- 111.0 seconds; P < .0001). Successful entry rates in the first attempt, CO2 consumptions, failed attempt rates, and overall intraoperative complication rates were similar. However, in the DTI group, 2 patients had mesenteric injuries, and 1 of them required conversion to open surgery due to the mesenteric hemorrhage. Conclusions: DTI in obese patients significantly shortens the entry time, but there can be severe complications with DTI when a nonoptical bladed trocar is used blindly. Actually, neither method can be recommended for entry into the abdomen in this population based on our results. If the surgeon has to choose a nonoptical trocar in bariatric surgery, preference for the VNI technique instead of the DTI technique is safer.Öğe Comparison of Harmonic scalpel and Ligasure devices in laparoscopic Roux-en-Y gastric bypass(Termedia Publishing House Ltd, 2017) Kirmizi, Serdar; Kayaalp, Cuneyt; Karagul, Servet; Tardu, Ali; Ertugrul, Ismail; Sumer, Fatih; Yagci, Mehmet AliIntroduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most preferred bariatric procedures in the world for surgical treatment of morbid obesity. The Harmonic scalpel (HS) and LigaSure (LS) are the most commonly used devices in laparoscopic surgery. As far as we know, there is no comparative study of the two energy devices in LRYGB for morbid obesity. Aim: To compare the intraoperative performances of the two energy devices in LRYGB for morbid obesity. Material and methods: The HS and LS were used in 43 and 42 cases, respectively. The patient demographics of both groups were comparable. The duration of the procedures (gastric pouch creation time and total operation time), quantity of bleeding (during gastric pouch creation and total quantities of bleeding) and the number of pneumoperitoneum desufflations due to smoking that impaired sight fields were recorded prospectively. Results: Gastric pouch creation time (HS: 22.5 +/- 9.5 vs. LS: 19.5 +/- 9.7 min, p = 0.15), bleeding during gastric pouch preparation (HS: 15.3 +/- 30.5 vs. LS: 17.5 +/- 31.3 ml, p = 0.74), total operation time (HS: 183.2 +/- 47 vs. LS: 165.3 +/- 37.1 min, p = 0.06) and total bleeding (HS: 110 +/- 195.5 vs. LS: 102.5 +/- 70 ml, p = 0.81) were similar in the two groups. Only the mean number of pneumoperitoneum desufflations due to smoking was lower in the HS group (HS: 0.28 +/- 0.49 vs. LS: 0.57 +/- 0.78, p = 0.04). Conclusions: The HS and LS performed similarly in LRYGB, with fewer desufflations from smoking in the HS group.Öğe Comparison of Natural Orifice Versus Transabdominal Specimen Extraction Following Laparoscopic Minor Hepatectomy(Springer India, 2022) Aydin, Mehmet Can; Bag, Yusuf Murat; Gunes, Orgun; Sumer, Fatih; Kayaalp, CuneytNatural orifice specimen extraction (NOSE) is an emerging technique usually preferred for colorectal resections or cholecystectomy. NOSE following laparoscopic liver resections is limited to case reports, and there is no previous study comparing the outcomes of NOSE and transabdominal (TA) specimen extraction. Our aim was to compare NOSE and TA specimen extraction methods following laparoscopic minor hepatectomy. Thirty-one patients undergoing laparoscopic minor hepatectomy between 2014 and 2020 were evaluated. The patients were divided into two groups as NOSE (n: 12) and TA (n: 19). The patients' demographics, preoperative and postoperative findings, pain, and cosmetic scores were compared. Female ratio was higher in the NOSE group (83.3% vs 31.6%, p=0.005); other demographics were similar. The median length of incision was 6 cm in the TA group but only trocar incisions in the NOSE group. There was no difference between intraoperative and postoperative findings except pain and cosmetic scores. Pain scores on postoperative days 1, 2, and 3 and in total were lower in the NOSE group (4.1 +/- 0.6 vs. 5.6 +/- 1.1, p=0.001; 2.2 +/- 04 vs. 4.1 +/- 0.9, p<0.001; 1.7 +/- 0.6 vs. 2.4 +/- 0.8, p=0.025; 8.1 +/- 1.4 vs. 12.2 +/- 2.5, p<0.001). In addition, patients in NOSE group had better cosmetic scores (9.2 +/- 0.6 versus 7.0 +/- 0.6, p<0.01). Laparoscopic minor hepatectomy combined with NOSE is a safe and effective procedure in selected patients with the advantages of less postoperative pain and better cosmesis. NOSE is ideal for female patients with high cosmetic expectancy.Öğe A Comparison of Natural Orifice Versus Transabdominal Specimen Extraction Following Laparoscopic Total Colectomy(Mary Ann Liebert, Inc, 2019) Gundogan, Ersin; Kayaalp, Cuneyt; Gunes, Orgun; Uylas, Ufuk; Sumer, FatihIntroduction: Natural orifice surgery has been increasingly used in colon surgery since the early 2000s. However, it is rarely used for total colectomy. In this study, we aimed to retrospectively compare natural orifice specimen extraction (NOSE) with transabdominal specimen extraction in patients undergoing laparoscopic total colectomy. Materials and Methods: Twenty-six patients who underwent laparoscopic total colectomy between 2013 and 2017 were enrolled and the patients were divided into two groups: NOSE (n = 13) and transabdominal group (n = 13). The patients' demographic characteristics, perioperative and postoperative outcomes, pathology results, visual analog scale scores, and cosmetic scores were compared. Results: There was no significant difference between the two groups in terms of demographic characteristics as well as perioperative and postoperative outcomes, including complications. Benign pathologies were more common in the NOSE group (85% versus 15%, P = .001). The pain scores of the postoperative first, second, and third days were significantly lower in the NOSE group 4.1 +/- 2.1 versus 7.1 +/- 1.3 (P = .005), 3.7 +/- 2.2 versus 6.0 +/- 1.5 (P = .003), and 2.2 +/- 2.0 versus 4.1 +/- 0.9 (P = .03), respectively. As expected, the mean cosmetic score was significantly better in the NOSE group (8.3 +/- 1.5 versus 6.7 +/- 1.8, P = .02). Conclusion: NOSE combined with laparoscopic total colectomy provided better patient comfort in benign diseases and small-sized malignant diseases.Öğe Comparison of open and laparoscopic gastrectomy for gastric cancer: a low volume center experience(Turkish Surgical Assoc, 2021) Yuksel, Adem; Coskun, Murat; Turgut, Hamdi Taner; Sumer, FatihObjective: In gastric cancer, laparoscopic gastrectomy is commonly performed in Asian countries. In other regions where tumor incidence is relatively low and patient characteristics are different, developments in this issue have been limited. In this study, we aimed to compare the early results for patients who underwent open or laparoscopic gastrectomy for gastric cancer in a low volume center. Material and Methods: We retrospectively analyzed the data of patients who underwent curative gastric resection (open gastrectomy n: 30; laparoscopic gastrectomy n: 30) by the same surgical team between 2014 and 2019. Results: The tumor was localized in 60% (36/60) of the patients in the proximal and middle 1/3 stomach. In laparoscopic gastrectomy group, the operation time was significantly longer (median, 297.5 vs 180 minutes; p<0.05). In open gastrectomy group, intraoperative blood loss (median 50 vs 150 ml; p<0.05) was significantly higher. Tumor negative surgical margin was achieved in all cases. Although the mean number of lymph nodes harvested in laparoscopic gastrectomy group was higher than the open surgery group, the difference was not statistically significant (28.2 +/- 11.48 vs 25.8 +/- 9.78, respectively; p=0.394). The rate of major complications (Clavien-Dindo >= grade 3) was less common in the laparoscopic group (6.7% vs 16.7%; p=0.642). Mortality was observed in four patients (2 patients open, 2 patients laparoscopic). Conclusion: In low-volume centers with advanced laparoscopic surgery experience, laparoscopic gastrectomy for gastric cancer can be performed with the risk of morbidity-mortality similar to open gastrectomy.Öğe Comparison of Stapled Versus Stapleless Sleeve Gastrectomy with Natural Orifice Specimen Extraction (NOSE)(Wolters Kluwer Medknow Publications, 2021) Kirmizi, Serdar; Kayaalp, Cuneyt; Karagul, Servet; Tardu, Ali; Ertugrul, Ismail; Sumer, FatihBackground: Sleeve gastrectomy is a stapler dependent bariatric procedure. A stapleless sleeve gastrectomy can be necessary for certain circumstances. Aims: Here, we aimed to show whether laparoscopic stapleless sleeve gastrectomy with natural orifice specimen extraction (NOSE) can be an alternative procedure o stapled sleeve gastrectomy. Patients and Methods: In the stapleless group (n = 6), no staplers were used and after vertical resection of the stomach by energy devices, the stomach remnant was closed by two rows of intracorporeal sutures. The resected specimen was removed through the mouth using an endoscopic snare. In the stapler group (n = 7), sleeve gastrectomy was carried out with linear stapler under the guidance of 36 Fr Bougie. The specimens were extracted from the left upper quadrant trocar site. Results: A total of 13 patients were compared (stapleless = 6 and stapled group = 7). All the sleeve gastrectomies were completed laparoscopically. The operative time was longer at 200 minutes (range 120-300) versus 120 minutes, (range 90-200) p = 0.07) and the amount of bleeding was higher at 100 ml (range 50-200) versus 30 ml (range 10-50) (p = 0.004) in the stapleless group. Leakage and gastrointestinal bleeding were seen in the stapleless group but no complications were found in the stapler group. No statistically significant difference was found between the metabolic outcomes of the two groups after the operation (p > 0.05). Decrease in BM at similar rates was observed in 5 postoperative year (stapleless group: 35 kg/m(2) (range 31-39) versus stapled group: 36.5 kg/m(2) (range 31-39), p > 0.05). Conclusion: Laparoscopic stapleless sleeve gastrectomy with natural orifice specimen extraction has longer procedure time, more blood loss and complications.Öğe Early endoscopic retrograde cholangiopancreatography after laparoscopic cholecystectomy can strain the occurrence of trocar site hernia(Baishideng Publishing Group Inc, 2014) Sumer, Fatih; Kayaalp, Cuneyt; Yagci, Mehmet Ali; Otan, Emrah; Kocaaslan, HuseyinThis study reports a 69-year-old, obese, female patient presenting with a biliary leakage after laparoscopic cholecystectomy for cholelithiasis. Closure of the umbilical trocar site had been neglected during the laparoscopic cholecystectomy. Early, on postoperative day five, endoscopic retrograde cholangiopancreatography (ERCP) requirement after laparoscopic cholecystectomy resolved the biliary leakage problem but resulted with a more complicated clinical picture with an intestinal obstruction and severe abdominal pain. Computed tomography revealed a strangulated hernia from the umbilical trocar site. Increased abdominal pressure during ERCP had strained the weak umbilical trocar site. Emergency surgical intervention through the umbilicus revealed an ischemic small bowel segment which was treated with resection and anastomosis. This report demonstrates that negligence of trocar site closure can result in very early herniation, particularly if an endoscopic intervention is required in the early postoperative period.(C) 2014 Baishideng Publishing Group Inc. All rights reserved.Öğe Educational Video Addition to the Bariatric Surgery Informed Consent Process: a Randomized Controlled Trial(Springer, 2020) Saglam, Kutay; Kayaalp, Cuneyt; Aktas, Aydin; Sumer, FatihObjective Bariatric surgery is not a risk-free procedure and requires lifelong patient compliance in the postoperative period. Although the risks involved in bariatric surgery and the importance of lifelong follow-ups in the postoperative period are explained to patients in detail through verbal and written informed consent, the strong desire for weight loss can sometimes cause patients and their families to be ignorant of the mentioned issues preoperatively. The objective of this study is to evaluate the effectiveness of preoperative informational videos at improving the comprehension of informed consent content in bariatric surgery candidates. Materials and Methods A total of 74 bariatric surgery candidates were randomized into two groups. The first group was given a usual verbal-written informed consent. The second group got an additional informing video presentation informed consent, in addition to the usual verbal-written informed consent. Then, both groups got a questionnaire evaluating their knowledge of bariatric surgery informed consent. The correct response scores and their relationship with patient demographics were analyzed. Results Both groups had similar demographic features. Video-presented group had higher scores in questionnaire (11.3 +/- 2.3 versus 9.4 +/- 1.7, p = 0.001). Subgroup analysis showed that health care workers (12.5 +/- 1.9 versus 10.3 +/- 2.2, p = 0.005) and university graduates (11.6 +/- 2.4 versus 10.1 +/- 2.1, p = 0.03) got better results in the questionnaire. In multivariate analysis, video-assisted informing was found to be the only independent variable for high questionnaire scores (p = 0.0001). Conclusions This study showed that video-assisted informed consent improves patients' comprehension prior to bariatric surgery. We recommend routine preoperative video-assisted informing for bariatric surgery candidates in addition to usual verbal-written informed consent.Öğe Effect of Abdominal Drain on Patient Comfort in Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Study(Mary Ann Liebert, Inc, 2021) Gundogan, Ersin; Gokler, Cihan; Sumer, Fatih; Kayaalp, CuneytIntroduction:Sleeve gastrectomy is probably the most preferred morbid obesity surgery. It is important to provide patient comfort and early return to daily life after sleeve gastrectomy. Our aim was to investigate the effects of drain use on postoperative patient comfort. Materials and Methods:Fifty patients were randomly divided into two groups as no-drain and with-drain. The demographic characteristics and the intraoperative and postoperative findings of the patients were examined. Results:There were no differences between the two groups in terms of demographic data, intraoperative and postoperative findings except visual analog scale (VAS) scores. Two patients (8%) in no-drain group required drain placement. In the intention-to-treat analyses of the drain and the no-drain groups (25:25), the VAS values were 4.3 +/- 1.9 versus 3.9 +/- 2.1 (p = 0.48), 2.4 +/- 1.4 versus 2.4 +/- 1.6 (p = 0.98), and 1.8 +/- 1.5 versus 0.9 +/- 1.0 (p = 0.01) on the 1st, 2nd, and 3rd days, respectively. In the per-protocol analyses (27:23), the VAS scores on the first 3 days were 4.3 +/- 1.9 versus 3.9 +/- 2.1 (p = 0.78), 2.4 +/- 1.4 versus 2.4 +/- 1.6 (p = 0.98), and 1.8 +/- 1.4 versus 1.0 +/- 1.1 (p = 0.03), respectively. Conclusions:Routine abdominal drain use in sleeve gastrectomy negatively affects postoperative patient comfort by increasing pain. Randomized controlled trials are needed about the requirement of routine drain use in sleeve gastrectomy.ClinicalTrials.govID: NCT04333979.Öğe Effect of nebivolol on liver regeneration in an experimental 70% partial hepatectomy model(Elsevier Singapore Pte Ltd, 2017) Sumer, Fatih; Colakoglu, Muhammet Kadri; Ozdemir, Yilmaz; Ozsay, Oguzhan; Ilter, Ozer; Bostanci, Erdal Birol; Akoglu, MusaBackground: Factors affecting liver regeneration are still relevant. The purpose of this study is to investigate the effect of nebivolol treatment on liver regeneration in rats in which 70% partial hepatectomy was performed. Methods: Three groups were created: the control group, the low dose group, and the high dose group, with 20 rats in each group and 70% hepatectomy was performed in all rats. Immediately after partial liver resection, 2 mL physiological saline solution was administered to the control group via oral gavage, 0.5 mg/kg nebivolol was administered via oral gavage to the low dose group and 2 mg/kg nebivolol was administered via oral gavage to the high dose group. On the 1st and 5th days after liver resection, 10 subjects were sacrificed from each group, and liver weights and the mitotic count and Ki-67 were measured. Results: Regenerating liver weight on the 1st and 5th days after partial hepatectomy was statistically different in the low dose and high dose nebivolol groups compared to the control group. Mitotic count on the 1st day after partial hepatectomy was significantly higher in the low dose and high dose nebivolol groups than the control group. There was no statistically significant difference detected between the three groups for the 5th day. On the 1st day, Ki-67 rates were significantly higher in both groups given nebivolol than the control group. However, 5th day results were not statistically significant. Conclusion: Nebivolol increases regeneration after partial hepatectomy in rats. (C) 2016 Asian Surgical Association and Taiwan Robotic Surgical Association. Publishing services by Elsevier B.V.Öğe Effects of Body Mass Index of Living Donors On Postoperative Course of Liver Function Tests(Lippincott Williams & Wilkins, 2015) Akbulut, Sami; Karakas, Serdar; Aydin, Cemalettin; Sumer, Fatih; Kayaalp, Cuneyt; Isik, Burak; Colak, Cemil[Abstract Not Available]
