Gastric Twist after Laparoscopic Sleeve Gastrectomy, Diagnosis and Management: A Case Series and Discussion

Late gastric twist after laparoscopic sleeve gastrectomy

“…In the late postoperative period they present dysphagia, gastroesophageal reflux, gastric vomiting and in some cases dumping syndrome. 4 López As a preventive measure against axial rotation of the gastric sleeve, some authors recommend fixation of the gastric sleeve by suturing the staple line to the greater omentum in order to recover the usual gastric shape, others recommend these fixation points to the gastrocolic ligament or double fixation to the gastrocolic ligament and to the edge of the greater omentum of the gastroepiploic vessels. 5 Likewise, they recommend an adequate posterior dissection of the stomach during gastrectomy to perform a symmetrical stapling of the anterior and posterior face to avoid twisting.…”

New Technique of Posterior Fixation of Tube With Fibrin Sealant Prevents Dysphagia in Patients Undergoing Sleeve Gastrectomy

“…12 During the performance of LSG, the stomach is released from gastrosplenic, gastrocolic, gastrophrenic, and posterior connections, which increases the risk of twist formation. 13 A GT can be classified according to the time of diagnosis as follows: intraoperative, early postoperative, and late postoperative. An early postoperative twist causes refractory nausea and intermittent vomiting of small amounts of gastric fluid and saliva.…”

“…A late postoperative twist is associated with dysphagia and GERD. 13 A GT can be diagnosed using postoperative passage radiography and endoscopy. In a GT, chronic dysphagia may result if the rotation is minimal.…”

Conceptos innovadores en cirugía bariátrica que sustentan el bypass gástrico con preservación gastroduodenal (bg-pg): una propuesta técnica

“…La colocación de un tubo más allá de la CA no garantiza la eliminación de las complicaciones estenóticas u obstructivas a ese nivel [18,27], pero el uso de bujías de alto calibre disminuye el riesgo de fístula [28]. Por tanto, subestimar de la contractilidad residual en la dinámica CAseno sería el factor más importante que contribuya a la generación de estas complicaciones y debe tenerse en cuenta para evitarlas, como en el diseño del BG-PG.…”