In those randomized to interrogation, the hiatus will be opened posteriorly during surgical procedure intervention with preservation of the phreno-esophageal ligament where possible, as per standard described techniques. Dissection into the mediastinum will be stopped if no hernia is seen or when appropriate intra-abdominal length of 2 cm of esophagus is created. Once opened, the Hiatal Surface Area will be measured, calculated and recorded and when possible, a photo taken of the area. Repair of the crura will then be performed around the sizing tube used to create the sleeve with enough space to allow a 5 mm instrument to be easily inserted. Permanent sutures will be placed posterior to the esophagus.

In those randomized without interrogation, the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach along the greater curvature. The procedure involves a longitudinal resection of the stomach starting from the antrum at the point 5-6 cm from the pylorus and finishing at the fundus close to the cardia.[1] The remaining gastric sleeve is calibrated with a bougie. Most surgeons prefer to use a bougie between 36-40 Fr with the procedure and the ideal approximate remaining size of the stomach after the procedure is about 150 mL.

Sleeve Gastrectomy

Weight-loss procedure to reduce the stomach.

Sleeve Gastrectomy Without Interrogation of Hiatus

Weight-loss procedure to reduce the stomach with hiatal repair.

Sleeve Gastrectomy With Interrogation of Hiatus

Cedars Sinai Medical Center

Hiatal Interrogation in Sleeve Gastrectomy

Hiatal Interrogation in Sleeve Gastrectomy (HIATUS):a Clinical Trial

Statistically significant change in total patients on PPI therapy for confirmed GERD (by either questionnaire or pH test confirmed GERD).

GERD (by either questionnaire or pH test confirmed GERD)

Statistically significant change in total patients on PPI therapy for confirmed GERD (by either questionnaire or pH test confirmed GERD)

Miguel Burch

Associate Director, Minimally Invasive Surgery

Cedars-Sinai Medical Center

Inflammatory Response

Metabolic Disturbance

Immune Suppression

26 g/day freeze-dried powder, 2 weeks duration

Blueberry

Placebo

Acute ingestion of bananas 0.2 g carb/kg every 15 min exercise with water

banana

No banana

North Carolina Research Campus, Human Performance Lab

Blueberries, Bananas, Exercise Recovery

The Combined Influence of Blueberry and Banana Consumption on Metabolic Recovery From 75-km Cycling Exercise Stress

75-km cycling time trial, with or without bananas

Targeted panel of 24 immune proteins including S100A8 and S100A12

Arachadonic acid oxidized derivatives from LC-MS-MS analysis

Appalachian State University

Dole Food Company

Blueberry freeze dried powder or placebo powder

Intervention, water and no banana carbohydrate: consume 3 ml/kg water every 15 min during 75 km cycling

Intervention, banana carbohydrate: ingest 0.2 g carbohydrate/kg body weight from Mini banana with 3 ml/kg water every 15 minutes during 75 km cycling

Intervention, banana carbohydrate: ingest 0.2 g carbohydrate/kg body weight from Cavendish banana with 3 ml/kg water every 15 minutes during 75 km cycling

Intervention: pure banana carbohydrate in sugar beverage; ingest 0.2 g carbohydrate/kg body weight from a 6% sugar beverage every 15 minutes during 75 km cycling (contains 60 grams sugar per liter using the same sugar profile found in Cavendish bananas)

Inflammation

Water

Ingest mini banana containing higher phenolics and carbohydrate concentration

Mini banana

Cavendish banana

Ingest 6% sugar beverage containing same glucose and fructose profile as banana

6% sugar beverage

Human Performance Lab, North Carolina Research Campus

Banana Cultivars and Exercise Performance and Recovery

Influence of Bananas Varying in Carbohydrate and Phenolic Content on Exercise Performance and Recovery

Total plasma concentrations of five inflammatory cytokines [monocyte chemoattractant protein-1 (MCP-1), tumor necrosis factor alpha (TNFα), IL-6, IL-8, and IL-10] will be determined using an electrochemiluminescence based solid-phase sandwich immunoassay (Meso Scale Discovery, Gaithersburg,MD, USA).

change in muscle glycogen using ultrasound

Gastrointestinal and mental symptoms, 1-12 Likert scale

Data will be shared through the Human Metabolome Database (HMDB) or the Scripps Metabolite and Tandem MS Database (METLIN)], other public web sites, and publication in the scientific literature. We will cooperate in making available cloud-based access to the data and associated informatics components within the general scientific community.

heartburn/musa balbisiana

Hiatal Interrogation in Sleeve Gastrectomy

Blueberries, Bananas, Exercise Recovery

Banana Cultivars and Exercise Performance and Recovery

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