A Strong Approach to a Weak Gastric Wall in Bariatric Surgery: Concurrent Diverticulectomy and Sleeve Gastrectomy

Abstract

A gastric diverticulum is a rare finding in which the wall of the stomach forms an abnormal saclike projection. Gastric diverticula can be problematic causing symptoms including but not limited to chronic gastroesophageal reflux, abdominal pain, and bloating. When a gastric diverticulum becomes symptomatic, removal is indicated. In specific cases, laparoscopic gastric diverticula resection can be completed with concurrent bariatric surgery. We report the perioperative approach used in a 34-year-old obese woman with a confirmed symptomatic gastric diverticulum undergoing a gastric diverticulum resection with a concurrent laparoscopic sleeve gastrectomy.

Management of Large Subcardial Diverticula in Sleeve Gastrectomy: Technical Tips

“…In the upper gastrointestinal series, a gastric diverticulum may show up as an image of saccular pouch of the gastric wall at the hydro-air level (shown in Figure 1). In the literature, some clinical cases of gastric diverticula have been reported, but there is little evidence on their management in bariatric surgery [9,10].…”

“…In the report by Wylie et al [10], the resection of the diverticulum was completed concurrently with a sleeve gastrectomy in a patient with obesity, symptomatic of the diverticulum. The preoperative endoscopy and upper gastrointestinal series revealed the diverticulum on the posterior gastric wall.…”