Concomitant Hiatal Hernia Repair with Sleeve Gastrectomy: A 5-Year Analysis

Clapp, Benjamin; Liggett, Evan; Barrientes, Ashtyn; Aguirre, Katherine; Marwaha, Vidur; Tyroch, Alan

doi:10.4293/jsls.2020.00066

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Complications of SG, including stenosis, angulation or kinking, are associated with increased intragastric pressure and GERD (Figure 1) [38]. Data regarding the optimal bougie size for weight loss and reduced reflux are mixed, but generally support a range of [36][37][38][39][40][41][42]. Overfilling of the gastric sleeve due to a large meal portion may result in reflux symptoms, and thus, patients should be counseled to gradually advance their diet from liquids to small portions of healthy, protein-rich foods.…”

Section: What Are the Underlying Mechanisms For De Novo Or Increased ...mentioning

confidence: 99%

“…In one study, 37% of 181 morbidly obese patients were noted to have a hiatal hernia during preoperative work-up for bariatric surgery [35]. Repair of the hiatal hernia, if present, at the time of SG is recommended to reduce the risk of postoperative GERD although hiatal hernia repair may pose a challenge in patients with large hernias, especially those associated with esophagitis or Barrett's esophagus [35,36]. Conditions in which there is an increase in intragastric pressure may lead to reflux.…”

Section: What Are the Underlying Mechanisms For De Novo Or Increased ...mentioning

confidence: 99%

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Current Management and Treatment Paradigms of Gastroesophageal Reflux Disease following Sleeve Gastrectomy

Masood,

Low,

Deal

et al. 2024

JCM

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Obesity is associated with serious comorbidities and economic implications. Bariatric surgery, most commonly Roux-en-Y gastric bypass and sleeve gastrectomy, are effective options for weight loss and the improvement of obesity-related comorbidities. With the growing obesity epidemic, there has been a concomitant rise in bariatric surgeries, particularly in sleeve gastrectomy, which has been the most widely performed bariatric surgery since 2013. Gastroesophageal reflux disease (GERD) is highly prevalent in obese individuals, can significantly impact quality of life and may lead to serious complications. Obesity and GERD both improve with weight loss. However, as the incidence of sleeve gastrectomy rises, recent data have revealed a risk of exacerbation of pre-existing GERD or the development of de novo GERD following sleeve gastrectomy. We performed a detailed review of GERD post-sleeve gastrectomy, including its overall incidence, pathophysiology and current treatment paradigms.

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Section: What Are the Underlying Mechanisms For De Novo Or Increased ...mentioning

confidence: 99%

Section: What Are the Underlying Mechanisms For De Novo Or Increased ...mentioning

confidence: 99%

Current Management and Treatment Paradigms of Gastroesophageal Reflux Disease following Sleeve Gastrectomy

Masood,

Low,

Deal

et al. 2024

JCM

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“…Despite some surgeons making decisions based on the presence of a hiatal hernia and preferring bypass surgeries when a hiatal hernia is observed via endoscopy, the tendency of some bariatric surgeons is to perform LSG with hiatal hernia repair during the same operation. Few studies have evaluated whether laparoscopic cholecystectomy is safe when performed at the same time, and although hiatal hernia repair is safe, there is controversy about its long-term effects on gastroesophageal reflux [27,28,29,30,31]. In our study, laparoscopic cholecystectomy was performed simultaneously with LSG in 3.6% of patients, hiatal hernia repair was performed simultaneously with LSG in 4.2% of patients, and both methods were performed simultaneously with LSG in 0.2% of patients (Table 3).…”

Section: Comparison Of the Omentopexy And Control Groupsmentioning

confidence: 99%

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

Kara,

Ozel,

Yardimci

2024

OBES SURG

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Background Laparoscopic sleeve gastrectomy (LSG) is a commonly performed type of bariatric surgery. Early complications of LSG include bleeding, leakage, pulmonary embolism, and surgical site infections. Most surgeons try to implement preventive methods, such as omentopexy. Staple line-imbrication, which has a difficult learning curve, often prevents complications. This study aimed to evaluate the effect of omentopexy on patients with imbricated LSG. Material and Methods The study applied a retrospective data analysis design to patients who underwent LSG between 2020 and 2023. All patients’ staple lines were imbricated, and patients were then divided into two groups: omentopexy group and control group. Patients’ demographic features, such as age, gender, height, weight, body mass index(BMI), bleeding, leakage, and reoperations, were recorded and examined retrospectively. Results A total of 1356 patients were included in the study (540 in omentopexy, 816 in control), of which the mean age was 37.9 ± 10.5 years, 82.3% were women, and mean BMI was 40.9 ± 5.8 kg/m2. The mean bleeding rate was 1.0% (1.3–0.7%), the mean leakage rate was 0.2% (0.2–0.2%, respectively), and the mean reoperation rate was 0.6% (0.7% and 0.5%, respectively). No statistically significant differences were observed. Conclusion Omentopexy is a technique that is widely used to prevent staple line complications. According to our study, omentopexy applied to an imbricated stapler line increased the operation time but did not affect bleeding or leakage ratios. This is the first study to evaluate the effect of omentopexy on imbricated staple lines. The findings of the study indicate that omentopexy has no additional benefit on early complications when using staple-line imbrication. Graphical Abstract

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“…Due to the risk of worsening the current situation and the need for revisional surgery, LSG is not the best option for patients with significant gastroesophageal reflux disease (GERD). The ASMBS released a statement declaring that severe GERD symptoms and Barrett's esophagus are relative contraindications to LSG [13]. Roux en Y gastric bypass, which has long been used as an anti-reflux procedure, should be recommended for this population.…”

Section: Preoperative Considerationsmentioning

confidence: 99%

Laparoscopic Sleeve Gastrectomy – Technical Tips and Pitfalls

Dalkılıç¹,

Gençtürk²,

Yılmaz³

et al. 2023

Bariatric Surgery - Past and Present

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Today, bariatric surgery is the most effective treatment for obesity, and the techniques continue to evolve. Laparoscopic sleeve gastrectomy, which is only one step of biliopancreatic diversion/duodenal switch surgery, has become the most common bariatric procedure due to its efficacy when performed alone. Additionally, the rate of complications has decreased as a result of increased technical experience and the development of stapler technology. The widespread adoption of laparoscopic sleeve gastrectomy is also attributable to its technical simplicity. Although it is assumed to be a simple procedure, mistakes at specific stages significantly increase the risk of complications. We focus on our method in detail, including all operative steps, which we believe is the simplest and most effective technique after performing over 5000 surgeries at our institution. Paying attention to the sleeve size, selecting the appropriate stapler, not narrowing the incisura angularis, resecting the fundus without getting too close to the esophagus, creating a smooth, non-rotating staple line, and suturing the staple line are highlighted.

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Concomitant Hiatal Hernia Repair with Sleeve Gastrectomy: A 5-Year Analysis

Cited by 5 publications

References 20 publications

Current Management and Treatment Paradigms of Gastroesophageal Reflux Disease following Sleeve Gastrectomy

Current Management and Treatment Paradigms of Gastroesophageal Reflux Disease following Sleeve Gastrectomy

Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy

Laparoscopic Sleeve Gastrectomy – Technical Tips and Pitfalls

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