Imed Ben Amor1,2,3, Vincent Casanova4, Geoffroy Vanbiervliet5, Jean Marc Bereder6, Richard Habitan7, Radwan Kassir8, Jean Gugenheim4. 1. Department of Bariatric Surgery, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France. benamor.i@outlook.fr. 2. Université nice Sophia Antipolis, Nice, France. benamor.i@outlook.fr. 3. IRCAN; Unité INSERM 1081, Nice, France. benamor.i@outlook.fr. 4. Department of Bariatric Surgery, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France. 5. Department of Gastroenterology, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France. 6. Department of Digestive Surgery, Archet II Hospital, University of Nice-Sophia-Antipolis, Nice, France. 7. Department of Digestive Surgery, Casablanca, Morocco. 8. Department of Digestive Surgery, CHU Félix Guyon, La réunion, Saint Denis, Paris, France.
Abstract
BACKGROUND: The Montpellier bariatric team has recently proposed some technical alternatives to decrease the rate of gastroesophageal reflux disease (GERD) after bariatric surgery and also to offer patients an alternative in case of contraindication to Roux-en-Y gastric bypass (RYGBP): the Nissen-Sleeve (N-Sleeve). OBJECTIVES: We present here the results from a cohort of patients that underwent an operation with this newly designed anti-reflux bariatric procedure N-Sleeve: Nissen valve added to a standard SG. METHODS: Data from a prospective, observational, and monocentric cohort. All consecutive patients presenting to the bariatric surgery department for a laparoscopic sleeve gastrectomy between 2016 and 2018 with GERD were included in the study. The fundus was stapled with a margin from the valve, and the valve was created with tissue at a distance from the greater curvature so as to avoid a double layer stapling of the stomach. RESULTS: A total of 70 patients were included in the study. Ninety percent of the cohort presented with a hiatal hernia at the time of surgery. No mortality was observed during the follow-up period. Concerning GERD, 76% of all patients had preoperative esophageal syndromes, whereas 21% were asymptomatic with associated esophagitis. Grade A-C esophagitis was present in 99% of the cohort, but no Barrett's esophagus was present. Fifty-six (80%) patients used PPIs regularly. At 1 year of follow-up, one patient was still symptomatic. CONCLUSIONS: Comparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
BACKGROUND: The Montpellier bariatric team has recently proposed some technical alternatives to decrease the rate of gastroesophageal reflux disease (GERD) after bariatric surgery and also to offer patients an alternative in case of contraindication to Roux-en-Y gastric bypass (RYGBP): the Nissen-Sleeve (N-Sleeve). OBJECTIVES: We present here the results from a cohort of patients that underwent an operation with this newly designed anti-reflux bariatric procedure N-Sleeve: Nissen valve added to a standard SG. METHODS: Data from a prospective, observational, and monocentric cohort. All consecutive patients presenting to the bariatric surgery department for a laparoscopic sleeve gastrectomy between 2016 and 2018 with GERD were included in the study. The fundus was stapled with a margin from the valve, and the valve was created with tissue at a distance from the greater curvature so as to avoid a double layer stapling of the stomach. RESULTS: A total of 70 patients were included in the study. Ninety percent of the cohort presented with a hiatal hernia at the time of surgery. No mortality was observed during the follow-up period. Concerning GERD, 76% of all patients had preoperative esophageal syndromes, whereas 21% were asymptomatic with associated esophagitis. Grade A-C esophagitis was present in 99% of the cohort, but no Barrett's esophagus was present. Fifty-six (80%) patients used PPIs regularly. At 1 year of follow-up, one patient was still symptomatic. CONCLUSIONS: Comparative trials remain necessary between N-Sleeve and standard bariatric procedures to refine the specific indications of each of them and determine the eventual role of the N-Sleeve.
Authors: Matthew M Hutter; Bruce D Schirmer; Daniel B Jones; Clifford Y Ko; Mark E Cohen; Ryan P Merkow; Ninh T Nguyen Journal: Ann Surg Date: 2011-09 Impact factor: 12.969
Authors: Lars Fischer; Caroline Hildebrandt; Thomas Bruckner; Hannes Kenngott; Georg R Linke; Tobias Gehrig; Markus W Büchler; Beat P Müller-Stich Journal: Obes Surg Date: 2012-05 Impact factor: 4.129
Authors: Judith W H 't Hart; Bo J Noordman; Laser U Biter; Ivonne Leeuwenburgh; Martin Dunkelgrun; Jan A Apers Journal: BMJ Open Date: 2022-06-10 Impact factor: 3.006