Patients requiring revisional bariatric surgery will be treated with a standard of care laparoscopic procedure.

Patients requiring revisional bariatric surgery will be treated with the same procedure but performed robotically.

Bariatric Surgery

Robotic Surgery

Using robotic techniques during any revesional bariatric surgery

Robotic bariatric surgery - revisional

Using laparoscopic techniques during any revesional bariatric surgery

Laparoscopic bariatric surgery - revisional

Robotic Versus Laparoscopic Techniques for Revisional Bariatric Surgery

A Randomized Study of Robotic Versus Laparoscopic Techniques for Revisional Bariatric Surgery

Any complication - Complication will be defined by the Clavien-Dindo classification and our primary outcome will be long-term complications higher than grade III. These will include leaks and bleeds.
Only complications related to the procedure, such as therapeutic endoscopy or reoperation will be counted.
3)

Readmission to the center within 30 days of the original procedure

Reinterventions for chronic surgical complications (such as stricture) will be assessed through the bariatric clinic.
Only reintenrtventinos related to the original procedure will be counted.

This is the change in weight from the date of operation 2) 3) 4) 5) Sleep apnea (binary, defined as no need for CPAP)

This is the change in BMI from the date of operation

This is a binary outcome relating to the resolution of diabetes from baseline defined as no need for medication

This is a binary outcome relating to the resolution of hypertension from baseline defined as no need for medication

This is a binary outcome relating to the resolution of sleep apnea from baseline defined as no need for medication

McMaster University

We will randomise 60 patients between robotic (30 patients) and laparoscopic revisional bariatric surgery (30 patients) to evaluate those procedures in terms of perioperative safety, weight loss and comorbidity resolution.

Once consent has been signed, the patient will be assigned to any of the two groups, using a computer-based randomization on REDCap and the patient will be assigned to the corresponding study arm.

Patients receive a fat-based enteral nutrition formula, which is routinely used as standard care in our ICU

Patients receive a glucose-based enteral nutrition formula, which is routinely used as standard care in our ICU

Hyperglycemia Stress

Patients receive Diben continously for 7 days

Diben, Fresenius Kabi

Patients receive Fresubin original fibre continously for 7 days

Fresubin original fibre, Fresenius Kabi

Medical University of Vienna

Enteral Nutrition and Glucose Homeostasis

Effect of Different Enteral Nutrition Formulas on Glucose Homeostasis

Marlene Wewalka

Patients with acute coronary syndrome with ST elevation and fibrinogen receiving a dose of 400 mg every 24 hours of Bezafibrate in addition to conventional anti-ischemic treatment

Patients with acute coronary syndrome with ST elevation and hyperfibrinogenemia who received only conventional anti-ischemic treatment

Acute Myocardial Infarction

Patients with ST elevation acute myocardial infarction (STEAMI) and with fibrinogen concentration >500 mg/dl at 72 h of evolution, were randomly assigned to bezafibrate 400 mg/day or just conventional therapy

Bezafibrate

Bezafibrate for Hyperfibrinogenemia in Acute Myocardial Infarction

Early Effect Of Bezafibrate On Fibrinogen Levels, Inflammatory Response And Clinical Impact, In Patients With ST Elevation Acute Myocardial Infarction

PT-Fibrinogen HS Plus kit (Beckman Coulter, Brea, CA) to determine prothrombin time and fibrinogen and to evaluate extrinsic pathway of coagulation in citrated human plasma using an auto-analyzer ACL-800 (Cobas, Roche Diagnostics, Indianapolis, IN) where fibrinogen levels are determined through turbidimetry.

Concentration of cytokines (IL-8, IL-1β, IL-6, IL-10, TNF e IL-12) measured by ELISA system (Biosource)

angina, reinfarction, heart failure, death, and combined endpoints

Any side effect that comes with the intake of bezafibrate

hypertriglyceridemia/erbrechen

Robotic Versus Laparoscopic Techniques for Revisional Bariatric Surgery

Enteral Nutrition and Glucose Homeostasis

Bezafibrate for Hyperfibrinogenemia in Acute Myocardial Infarction

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