Personalized Procedure Of T2 Diabetes Mellitus Treatment: Technique Improvement On A Swine Model

Description: In morbid obese patient the surgical procedures of RYGB and Biliopancreatic Diversion resolve obesity problem in 80.3% up to 95.1% causes. When the Body Mass Index is less than 35 the prognosis after surgery is good and in 90% improvement is possible. The aim of this study is to assess if the procedure of sleeve gastrectomy together with duodeno-jejunostomy with an intact pylorus, is applicable. The surveys were made on a swine model. The preoperative assumptions are: 1.decrease level of the greline 2.diversion of the duodenum 3.mobility of the distal intestine increasing 4.better control of the weight and caloric intake. Procedure: With agreement of the etics comitee, the procedure was applided on 5 York pigs. Four ports were used and greater stomach curvature was dissected 3 cm above the pylorus, with the help of the harmonic scalpel. The duodenum vasculature was intact while duodenum was cut with stapler. Gastric duct was made de novo and continuity, with classical duodenostomy, was provided. Diet was introduced on the POD1. Results: Median duration time of the procedure was 45.8+-14.6 min. One mortal case, caused by malignant hyperthermia, occured. Other complications were not noted. SG-PPDJ resulted well in the 12 weeks follow-up period. Conclusion: The advantages of the SG-PPDJ procedure in pigs are length of the intervention and a single anastamosis. This type of surgery can be in the future applied in obese patients with diabetes mellitus type 2. Further studies are needed in order to assess metabolic outcomes. Authors: German Rosero MD., Fernando Casabon MD., Liliana Silva MD., L.J Espana MD., Tito Ortega MS.