Ronit T Yehoshua

Tel Aviv University, Tell Afif, Tel Aviv, Israel

Are you Ronit T Yehoshua?

Claim your profile

Publications (3)9.31 Total impact

  • Source
    [show abstract] [hide abstract]
    ABSTRACT: Background Aiming to clarify the mechanism of weight loss after the restrictive bariatric procedure of sleeve gastrectomy (LSG), the volumes and pressures of the stomach, of the removed part, and of the remaining sleeve were measured in 20 morbidly obese patients. Methods The technique used consisted of occlusion of the pylorus with a laparoscopic clamp and of the gastroesophageal junction with a special orogastric tube connected to a manometer. Instillation of methylene-blue-colored saline via the tube was continued until the intraluminal pressure increased sharply, or the inflated stomach reached 2,000 cc. After recording of measurements, LSG was performed. Results Mean volume of the entire stomach was 1,553 cc (600–2,000 cc) and that of the sleeve 129 cc (90–220 cc), i.e., 10% (4–17%) and that of the removed stomach was 795 cc (400–1,500 cc). The mean basal intragastric pressure of the whole stomach after insufflations of the abdominal cavity with CO2 to 15 mmHg was 19 mmHg (11–26 mmHg); after occlusion and filling with saline it was 34 mmHg (21–45 mmHg). In the sleeved stomach, mean basal pressure was similar 18 mmHg (6–28 mmHg); when filled with saline, pressure rose to 43 mmHg (32–58 mmHg). The removed stomach had a mean pressure of 26 mmHg (12–47 mmHg). There were no postoperative complications and no mortality. Conclusions The notably higher pressure in the sleeve, reflecting its markedly lesser distensibility compared to that of the whole stomach and of the removed fundus, indicates that this may be an important element in the mechanism of weight loss.
    Obesity Surgery 02/2009; 19(1):134. · 3.10 Impact Factor
  • Source
    [show abstract] [hide abstract]
    ABSTRACT: In recent years, laparoscopic sleeve gastrectomy (LSG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. Of continuing concern are the rate of postoperative complications and the lack of consensus as to surgical technique. A prospective study assessment was made of 120 consecutive morbidly obese patients with body mass index (BMI) of 43+/-5 (30 to 63), who underwent LSG using the following technique: (1) division of the vascular supply of the greater gastric curvature and application of the linear stapler-cutter device beginning at 6-7 cm from the pylorus so that part of the antrum remains; (2) inversion of the staple line by placement of a seroserosal continuous suture close to the staple line; (3) use of a 48 Fr bougie so as to avoid possible stricture; (4) firing of the stapler parallel to the bougie to make the sleeve as narrow as possible and prevent segmental dilatation. Intraoperative difficulties were encountered in four patients. There were no postoperative complications-no hemorrhage from the staple line, no anastomotic leakage or stricture, and no mortality. In 20 patients prior to the sleeve procedure, a gastric band was removed. During a median follow-up of 11.7 months (range 2-31 months), percent of excess BMI lost reached 53+/-24% and the BMI decreased from 43+/-5 to 34+/-5 kg/m(2). Patient satisfaction scoring (1-4) at least 1 year after surgery was 3.6+/-0.8. The good early results obtained with the above-outlined surgical technique in 120 consecutive patients undergoing LSG indicate that it is a safe and effective procedure for morbid obesity. However, long-term results are still pending.
    Obesity Surgery 09/2008; 18(12):1567-70. · 3.10 Impact Factor
  • [show abstract] [hide abstract]
    ABSTRACT: Aiming to clarify the mechanism of weight loss after the restrictive bariatric procedure of sleeve gastrectomy (LSG), the volumes and pressures of the stomach, of the removed part, and of the remaining sleeve were measured in 20 morbidly obese patients. The technique used consisted of occlusion of the pylorus with a laparoscopic clamp and of the gastroesophageal junction with a special orogastric tube connected to a manometer. Instillation of methylene-blue-colored saline via the tube was continued until the intraluminal pressure increased sharply, or the inflated stomach reached 2,000 cc. After recording of measurements, LSG was performed. Mean volume of the entire stomach was 1,553 cc (600-2,000 cc) and that of the sleeve 129 cc (90-220 cc), i.e., 10% (4-17%) and that of the removed stomach was 795 cc (400-1,500 cc). The mean basal intragastric pressure of the whole stomach after insufflations of the abdominal cavity with CO(2) to 15 mmHg was 19 mmHg (11-26 mmHg); after occlusion and filling with saline it was 34 mmHg (21-45 mmHg). In the sleeved stomach, mean basal pressure was similar 18 mmHg (6-28 mmHg); when filled with saline, pressure rose to 43 mmHg (32-58 mmHg). The removed stomach had a mean pressure of 26 mmHg (12-47 mmHg). There were no postoperative complications and no mortality. The notably higher pressure in the sleeve, reflecting its markedly lesser distensibility compared to that of the whole stomach and of the removed fundus, indicates that this may be an important element in the mechanism of weight loss.
    Obesity Surgery 07/2008; 18(9):1083-8. · 3.10 Impact Factor