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La Crosse, WI, United States

Baker M.T.,Gundersen Lutheran Health System
Surgical Clinics of North America | Year: 2011

The search for the ideal weight loss operation began more than 50 years ago. Surgical pioneers developed innovative procedures that initially created malabsorption, then restricted volume intake, and eventually combined both techniques. Variations, alterations, and modifications of these original procedures, combined with intense efforts to follow and document outcomes, have led to the evolution of modern bariatric surgery. More recent research has focused on the hormonal and metabolic effects of these procedures. These discoveries at the cellular level will help develop possible mechanisms of weight loss and comorbidity reduction beyond the traditional explanation of reduced food consumption and malabsorption. © 2011 Elsevier Inc. Source


Farley N.E.,Gundersen Lutheran Health System
The International journal of oral & maxillofacial implants | Year: 2013

Recent clinical studies have shown that implant placement is highly predictable with computer-generated surgical guides; however, the reliability of these guides has not been compared to that of conventional guides clinically. This study aimed to compare the accuracy of reproducing planned implant positions with computer-generated and conventional surgical guides using a split-mouth design. Ten patients received two implants each in symmetric locations. All implants were planned virtually using a software program and information from cone beam computed tomographic scans taken with scan appliances in place. Patients were randomly selected for computer-aided design/computer-assisted manufacture (CAD/CAM)-guided implant placement on their right or left side. Conventional guides were used on the contralateral side. Patients underwent operative cone beam computed tomography postoperatively. Planned and actual implant positions were compared using three-dimensional analyses capable of measuring volume overlap as well as differences in angles and coronal and apical positions. Results were compared using a mixed-model repeated-measures analysis of variance and were further analyzed using a Bartlett test for unequal variance (α = .05). Implants placed with CAD/CAM guides were closer to the planned positions in all eight categories examined. However, statistically significant differences were shown only for coronal horizontal distances. It was also shown that CAD/CAM guides had less variability than conventional guides, which was statistically significant for apical distance. Implants placed using CAD/CAM surgical guides provided greater accuracy in a lateral direction than conventional guides. In addition, CAD/CAM guides were more consistent in their deviation from the planned locations than conventional guides. Source


Al Harakeh A.B.,Gundersen Lutheran Health System
Surgical Clinics of North America | Year: 2011

Despite the well-documented safety of laparoscopic RYGB, several short-term and long-term complications, with varying degrees of morbidity and mortality risk, are known to occur. Bariatric surgeons, all too familiar with these complications, should be knowledgeable in risk-reduction strategies to minimize the incidence of complication occurrence and recurrence. Bariatric and nonbariatric surgeons who evaluate and treat abdominal pain should be familiar with these complications to facilitate early recognition and intervention, thereby minimizing the associated morbidity and mortality. © 2011 Elsevier Inc. Source


Kothari S.N.,Gundersen Lutheran Health System
Surgical Clinics of North America | Year: 2011

This article reviews the use of radiological imaging in the post-gastric bypass patient. A thorough understanding of the reconstructed anatomy is critical to interpret imaging abnormalities, when present. Radiological imaging can help guide the surgeon's management in this specific patient population. © 2011 Elsevier Inc. Source


Jarman B.T.,Gundersen Lutheran Health System
Surgical Clinics of North America | Year: 2011

There is a variety of options available to image the small bowel depending on the clinical scenario. This article describes multiple imaging options and focuses on several clinical scenarios common to general surgeons. © 2011 Elsevier Inc. Source

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