BACKGROUND: Laparoscopic sleeve gastrectomy for morbid obesity is associated with a high incidence of postoperative permanent heartburn as a result of gastroesophageal reflux. In order to avoid this complication, the authors developed a new technique, combining the creation of a very long and narrow vertical gastroplasty with an antireflux procedure. METHOD: The new operation was performed in 3 patients with BMI 40, 46 and 50 (1 male, 2 females). All the procedures were conducted laparoscopically using 6 trocars. The greater curvature of the stomach was mobilized in the antral region. A primary hole in both walls of the stomach was made in the antrum 5-7 cm proximal to the pylorus. Starting from this hole, the stomach was stapled and divided along a 33-Fr bougie to the angle of His, creating a long (15-20 cm), narrow tube. The divided fundus was then passed behind the mobilized abdominal part of the esophagus and a 360 degrees wrap was made (as in a Nissen procedure). RESULTS: None of the 3 patients developed complications. Excess BMI loss at 5 to 7 months has been good. No signs of esophagitis have been revealed during postoperative upper GI endoscopy. CONCLUSION: This operation is technically simple. Preliminary early postoperative results regarding its antireflux and weight-loss effects are encouraging.
BACKGROUND: Laparoscopic sleeve gastrectomy for morbid obesity is associated with a high incidence of postoperative permanent heartburn as a result of gastroesophageal reflux. In order to avoid this complication, the authors developed a new technique, combining the creation of a very long and narrow vertical gastroplasty with an antireflux procedure. METHOD: The new operation was performed in 3 patients with BMI 40, 46 and 50 (1 male, 2 females). All the procedures were conducted laparoscopically using 6 trocars. The greater curvature of the stomach was mobilized in the antral region. A primary hole in both walls of the stomach was made in the antrum 5-7 cm proximal to the pylorus. Starting from this hole, the stomach was stapled and divided along a 33-Fr bougie to the angle of His, creating a long (15-20 cm), narrow tube. The divided fundus was then passed behind the mobilized abdominal part of the esophagus and a 360 degrees wrap was made (as in a Nissen procedure). RESULTS: None of the 3 patients developed complications. Excess BMI loss at 5 to 7 months has been good. No signs of esophagitis have been revealed during postoperative upper GI endoscopy. CONCLUSION: This operation is technically simple. Preliminary early postoperative results regarding its antireflux and weight-loss effects are encouraging.
Authors: D Cottam; F G Qureshi; S G Mattar; S Sharma; S Holover; G Bonanomi; R Ramanathan; P Schauer Journal: Surg Endosc Date: 2006-04-22 Impact factor: 4.584
Authors: Felix B Langer; Arthur Bohdjalian; Franz X Felberbauer; Edith Fleischmann; Mir A Reza Hoda; Bernhard Ludvik; Johannes Zacherl; Raimund Jakesz; Gerhard Prager Journal: Obes Surg Date: 2006-02 Impact factor: 4.129