Rudolf Weiner

• MD, Professor for surgery
• Head of Department at Klinikum Offenbach GmbH

Reoperations due to failures constitute an essential but challenging part of bariatric surgery practice today. The aim of this study was to evaluate the perioperative safety, efficacy, and postoperative quality of life in patients with biliopancreatic diversion (BPD), after failed vertical banded gastroplasty (VBG). Twelve patients after failed or...

Gastric electrical stimulation synchronized to the refractory period of gastric electrical activity and applied during meals was evaluated for safety and for improvement of body weight and glycemic control in obese type 2 diabetes. The study involved obese diabetic type 2 (ODM) patients in a multicenter open-label European feasibility trial. A tota...

Background: The Edmonton Obesity Staging System (EOSS) is a more comprehensive measure of obesity-related diseases and predictor of mortality than body mass index (BMI) or waist circumference. Its application for the selection of obese patients for obesity surgery has been suggested. Objectives: The aim of this study was to determine whether the...

The number of obese and morbidly obese adolescents is increasing in the western industrialized world. Approximately, 7%of US 18-year olds already meet thedefinition of extreme obesity and that number is growing every year.In Germany the number of morbidly obese children and adolescents has increased dramatically; 10-20 of the German school children...

Metabolic surgery is internationally well-established for the treatment of obesity and its comorbidities. The numbers of procedures performed is steadily increasing. The results of surgery are superior in comparison to conservative treatment options regarding weight loss and resolution of comorbidities. The insufficiency of suture lines is a well-k...

Background: The current situation in obesity and metabolic surgery since January 2005 has been investigated with the help of the quality assurance study on surgical therapy for obesity = German Bariatric Surgery Registry (GBSR). The data were acquired and analysed in cooperation with the Institute for Quality Assurance in Surgical Medicine at the O...

The purpose of this study was to review the incidence of incidental gastrointestinal stromal tumors (GISTs) in a cohort of morbidly obese patients undergoing laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y gastric bypass (RYGB), analyzing surgery indication, morbidity, and follow-up data. All cases with incidental GISTs found were reviewed. Two...

Bariatric surgery outcomes have been examined in Germany since January 1, 2005. All data were registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. The data were collected from an online data bank. Data collection began in 2005 for gastric banding (GB) and Roux-en-Y...

Background: Obesity surgery is acknowledged as a highly effective therapy for morbidly obese patients. Beneficial short-term effects on common comorbidities are practically undisputed, but a growing data pool from long-term follow-up reveals increasing evidence of potentially severe nutritional and pharmacological consequences. Aims: To assess t...

Since January 1 2005, the outcomes of bariatric surgeries have been recorded in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg. Data are collected in an online data bank. Data collection began in 2005 for the results of Roux-en-Y-Gastric Bypa...

Increasing numbers of interventions for obesity and metabolic surgery have led to an increase of primary bariatric operations as well as redo operations and revisional surgery after various primary bariatric procedures. Evidence-based guidelines for indications and choice of procedure for revisional surgery do not currently exist. The spectrum of v...

Laparoscopic sleeve gastrectomy (LSG) is currently being performed with increasing frequency worldwide. It offers an excellent weight loss and resolution of comorbidities in the short term with a very low incidence of complications. However, the ever present risk of a staple line leak is still a major concern. Since 2005, data from obese patients t...

Since 1 January 2005, bariatric surgery has been monitored in Germany. All related data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Data collection regarding obesity and metabolic surgery was started in an online database in 2005. Follow-up data are co...

Bariatric surgery is known to be the most effective and long-lasting treatment for morbid obesity and associated comorbidities. These comorbidities together with cardiopulmonary decompensation make morbidly obese patients a high risk group for operative interventions. Early detection of postoperative complications is a challenging task in these pat...

Background: Since January 2005, the situation of metabolic and obesity surgery in Germany has been constantly evaluated by the German Bariatric Surgery Registry (GBSR). Data registration is performed using an internet online database with prospective data collection. All registered data were analysed in cooperation with the Institute of Quality As...

Background Since 1 January 2005, the situation of bariatric surgery has been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Methods Data collection on the results of gastric banding procedures was started in 2005, and the da...

In 2012, an expert panel composed of presidents of each of the societies, the European Chapter of the International Federation for the Surgery of Obesity (IFSO-EC), and of the European Association for the Study of Obesity (EASO), as well as of the chair of EASO Obesity Management Task Force (EASO OMTF) and other key representatives from IFSO-EC and...

In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity - European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed t...

Objective: To examine the safety and effectiveness of adolescent bariatric surgery and to improve treatment recommendations for this age group. Design: Prospective longitudinal registry. Since January 2005, patients undergoing bariatric surgery in Germany are enlisted in an online registry called 'study for quality assurance in obesity surgeries...

Since 1 January 2005, the outcomes of bariatric surgeries have been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at Otto-von-Guericke University Magdeburg. Data are collected in an online data bank. Data collection began in 2005 for the results of gastric banding (GB) a...

Obesity and diabetes usually co-exist. Obesity surgery seems to offer solutions for both. The objective of this study was to show the effect of obesity surgery on the diabetic profile. Data on obesity surgery in Germany (2005-2011) were collected from the Institute of Quality Assurance at the research university. Follow-up of the diabetic profile a...

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG) are the most common obesity surgeries. Their early complications may prolong hospital stay (HS). Data for patients who underwent LRYGB and LSG in our clinic from 2009 through August 2012 were collected. Early post-operative complications prolonging HS (>5 days)...

Background. Evidence-based data on optimal approach for prophylaxis of deep venous thrombosis (VTE) and pulmonary embolism (PE) in bariatric operations is discussed. Using antithrombotic prophylaxis weight adjusted the risk of VTE and its complications have to be balanced with the increased bleeding risk. Methods. Since 2005 the current situation f...

Background: Since January 1st 2005, the situation of bariatric surgery has been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of Magdeburg. Methods: The voluntary data registration occurs in an internet online data bank. All primary...

Since 1 January 2005, the situation of bariatric surgery has been examined in Germany. All data are registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Data are registered in an internet online database. Data collection on the results of sleeve gastrectomy was sta...

Background: Since January 1st of 2005, the situation of bariatric surgery is being analyzed in Germany. The data is registered prospectively in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University Magdeburg. Methods: The data is registered through an online database which includes all information for pr...

Sleeve gastrectomy is gaining popularity whether as a primary, staged or revisional operation. The aim of this study is to evaluate the perioperative safety and the learning curve for laparoscopic sleeve gastrectomy (LSG). We performed a retrospective review of the prospectively collected data for all patients who underwent LSG for the treatment of...

Ulcers at the gastrojejunostomy site are a common problem after gastric surgery. Their postoperative development seems to be associated with Helicobacter pylori-related gastritis or abuse of nicotine, alcohol or non-steroidal anti-inflammatory drugs (NSAIDs), but is also dependent on the choice of surgical method (Roux-en-Y or B-II gastric bypass)....

Worldwide, the incidence of morbid obesity is increasing, and surgery is the only effective longterm treatment. Laparoscopic sleeve gastrectomy (LSG) is associated with acceptable weight loss and reduced comorbidities. It is considered a safe procedure with sporadic complications. This publication aims to describe failures of LSG in terms of ineffe...

The growing enthusiasm to perform laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients exposes also the complications associated with this type of surgery. LSG is not only performed in super-super-obese patients, but in addition has also its standing as a procedure in patients with multiple intraabdominal adhesions based on prior surger...

The prevalence of overweight and obesity and the number of surgical interventions for morbid obesity are increasing worldwide. Conservative therapy is largely ineffective in producing maintained weight loss in morbidly obese patients and surgery is therefore increasingly considered as the only available option for these patients. Until approximatel...

Background: Overweight and obesity are the most significant risk factors for the development of hepatic steatosis, non-alcoholic steatohepatitis (NASH) and non-alcoholic fatty liver disease (NAFLD) in children and adults. Both have been increasingly implicated in the genesis of hepatic fibrosis and cirrhosis. However, no consensus exists about whe...

Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective forms of treatment for metabolic diseases and conditions including type 2 diabetes, hypertension, high cholesterol levels, non-alcoholic fatty liver dise...

Bariatric surgery is known to be the most effective and long lasting treatment for morbid obesity and many related conditions, but now mounting evidence suggests it may be among the most effective forms of treatment for metabolic diseases and conditions including type 2 diabetes, hypertension, high cholesterol levels, non-alcoholic fatty liver dise...

Bardet-Biedl syndrome (BBS) is a rare genetic disorder characterized by a wide range of phenotypic variability and associated with the development of life-threatening obesity. Birth weight tends to be normal, but rapid weight gain begins after the first year, probably due to polyphagia rather than abnormalities in energy metabolism. A morbidly obes...

Since January 1st, 2005, the current situation for bariatric surgery has been examined by means of a voluntary quality assurance study in Germany with a multicenter design in which 38 hospitals and surgical departments participated. The data are registered in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke Un...

Background: The temporary use of a gastric balloon for the treatment of obesity grade 1 and 2 is increasing worldwide,whereas in grade 3 obesity, it is implanted as a tool for preoperative adjuvant weight loss. The aim of this retrospective cohort analysis is to evaluate the effectiveness of weight reduction and to describe the risk profile of the...

The implantation of an intragastric balloon constitutes a short-term effective non-surgical intervention to lose weight. The aim of this study was to evaluate retrospectively the clinical outcome and safety of gastric balloon therapy (GBT) in extremely obese patients. One hundred and nine super- and super-super-obese patients, 64 males and 45 femal...

The Bariatric Quality of Life Index (BQL) was created and validated as a nine-factor model in 2005 for the measurement of quality of life (QoL) in patients before and after bariatric surgery.Even though the results were acceptable, the statistical structure of the test was very unclear. A total of 466 patients were enrolled in an ongoing prospectiv...

Beginning January 1, 2005, the status and outcomes of bariatric surgery were examined in Germany. Data are registered in cooperation with the An-Institute of quality assurance in surgery at the Otto-von-Guericke-University Magdeburg. The objective of this study was to examine the morbidity and mortality rates secondary to sleeve gastrectomy (SG) in...

Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Ottovon-Guericke University of Magdeburg (Germany) since...

Sleeve gastrectomy (SG) was initially described as a first-step procedure followed by either biliopancreatic diversion with duodenal switch or Roux-en-Y gastric bypass in super-super obese patients. Multiple recent reports have documented SG as single therapy in the treatment of morbid obesity. However,the indications for this procedure are still u...

Gastric balloon therapy (GBT) is a temporary, nonsurgical treatment for obesity. This retrospective study evaluates safety and efficacy of GBT in obese patients. The BioEnterics. Intragastric Balloon (BIB) was endoscopically implanted into each patient's stomach and inflated with saline (450-750 ml). Extraction was planned after 6 months. Data from...

Minimally invasive bariatric procedures next to becoming more and more popular have established a new field of applications for carbon dioxide (CO2) insufflators. In laparoscopic bariatric procedures, gas is used to insufflate the peritoneal cavity and increase the intra-abdominal pressure up to 15 mm Hg for optimal exposure and a suitable operatin...

The temporary use of a gastric balloon for the treatment of obesity grade 1 and 2 is increasing worldwide,whereas in grade 3 obesity, it is implanted as a tool for preoperative adjuvant weight loss. The aim of this retrospective cohort analysis is to evaluate the effectiveness of weight reduction and to describe the risk profile of the method. Retr...

Patients who undergo bariatric operations are at high riskof venous thromboembolism (VTE), with the incidence ofperioperative pulmonary embolism (PE) estimated at .85–.9% [1,2]. VTE remains the leading cause of death of thebariatric surgical patient during the perioperative period [3].PE accounts for 50% of deaths after laparoscopic or opengastric...

Since January 1st 2005, the situation of bariatric surgery in Germany has been examined. The data are registered in cooperation with the Institute of Quality Assurance in Surgery at the Otto-von-Guericke-University Magdeburg. The data registration took place prospectively in an internet online data base. All primary bariatric procedures performed s...

Most studies on bariatric surgery outcomes are performed as clinical trials or reflect the clinical experience in single centers. The status of bariatric surgery in Germany has been examined since January 1st, 2005 with the cooperation of clinics and hospitals at the Institute of Quality Assurance in Surgery at the Otto-von-Guericke University of M...

The prevalence of obesity and the number of surgeries for morbid obesity are increasing worldwide. Conservative therapy is largely ineffective in producing maintenance of weight loss in morbidly obese patients, and surgery is therefore increasingly considered as the only available option for these patients. Until approximately 15 years ago, many pa...

The only effective treatment for patients with morbid obesity is surgery. Laparoscopic bariatric surgery has become quite popular in attempts to decrease the morbidity associated with laparotomy. The aim of this study was to assess the safety and efficiency by using SurgASSIST(R) for performing the gastrojejunostomy in laparoscopic Roux-en-Y gastri...

Zusammenfassung Neue Schlagzeiten gehen um die Welt: „Adipositaschirurgie kann Diabetes heilen“, nachdem die erste randomisierte kontrollierte Studie über die Effektivität des laparoskopisch implantierten steuerbaren Magenbandes (LAGB) auf den Typ-2-Diabetes in JAMA publiziert wurde. Den Adipositaschirurgen ist diese Tatsache seit Jahren wohl bekan...

Adjustable silicone gastric banding (ASGB) is an effective treatment in morbid obesity. Band migration is a long-term complication. Causes, clinical symptoms, timing and incidence are investigated in single centres only. In Germany, since January 1st, 2005, practice in bariatric surgery has been investigated in German prospective multicenter trial...

Die operative Behandlung der extremen Adipositas (morbide Adipositas) ist derzeit die einzige effektive Therapie, die den Betroffenen eine deutliche und langfristige Gewichtsreduktion ermoglicht. Ihr Ziel ist die Beseitigung oder Besserung der Komorbiditaten, die die unmittelbaren Folgen der extremen Fettansammlung sind. Das metabolische Syndrom ka...

In 2005, for the first time in European history, an extraordinary expert panel named BSCG (Bariatric Scientific Collaborative Group), was appointed through joint effort of the major European scientific societies which are active in the field of obesity management. Societies that constituted this panel were: IFSO - International Federation for the S...

The prevalence of obesity and the number of surgeries for morbid obesity are increasing worldwide. Conservative therapy is largely ineffective in producing maintenance of weight loss in morbidly obese patients, and surgery is therefore increasingly considered as the only available option for these patients. Until approximately 15 years ago, many pa...

Die Zunahme der morbiden Adipositas und insbesondere der extremen Formen (super-obese patients) mit einem BMI >50 kg/m2 verlangt nach einer operativen Behandlung und der Suche nach Verfahren, die in diesen Fällen eine Gewichtsreduktion mit niedriger Morbidität erlauben. Die Schlauchmagenbildung (SMB; engl.: sleeve gastrectomy [SG]) war ursprünglich...

Zusammenfassung Hintergrund: Seit dem 1.1.2005 wird der aktuelle Stand der bariatrischen Chirurgie in Deutschland analysiert. Die Daten werden in Zusammenarbeit mit dem An-Institut für Qualitätssicherung in der Operativen Medizin an der Ottovon-Guericke-Universität Magdeburg erfasst und ausgewertet. Methoden: Die Datenerfassung erfolgt prospektiv m...

Background: Although the efficacy of laparoscopic sleeve gastrectomy (LSG) for morbidly obese patients with a BMI of <50 kg/m2, the incidence of weight gain by change of eating behaviors, and gastric dilatation following LSG have not been investigated thus far, LSG is becoming more common as a single-stage operation for the treatment morbid obesit...

It has already been demonstrated that laparoscopic adjustable gastric banding (LAGB) is a safe and effective alternative to other permanent bariatric surgery techniques. Although clinical complications have been managed through improvements in surgical techniques, port-related complications and adjustment process inefficiencies have persisted. To r...