Hiatal Repair During Laparoscopic Sleeve Gastrectomy May Limit GERD Symptoms Hiatal Repair During Laparoscopic Sleeve Gastrectomy May Limit GERD Symptoms

Repair of hiatal laxity and herniation during laparoscopic sleeve gastrectomy (LSG) for obesity improves symptoms of gastroesophageal reflux disease (GERD), according to a new study.Reuters Health Information
Source: Medscape General Surgery Headlines - Category: Surgery Tags: Gastroenterology News Source Type: news

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Gastroesophageal reflux disease (GERD) has a reported incidence of between 10% and 20% in Western populations with an even higher incidence in populations with obesity [1]. The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone laparoscopic Roux-en-Y gastric bypass (LRYGB). De Goot et  al. [2], in their 2009 meta-analysis, demonstrated improvement in GERD in people with obesity after LRYGB.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Video case report Source Type: research
Gastroesophageal reflux disease (GERD) has a reported incidence of between 10 to 20% in western populations with an even higher incidence in populations with obesity (1). The vast majority of patients are managed medically with surgical intervention undertaken in those with recalcitrant GERD. Populations with obesity and recalcitrant GERD who are interested in weight loss surgery have historically undergone Laparoscopic Roux En Y Gastric Bypass (LRYGB). De Goot et al in their 2009 meta-analysis demonstrated improvement in GERD in people with obesity following LRYGB(2).
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
Hiatal hernia (HH) repair during laparoscopic sleeve gastrectomy (LSG) has been advocated to reduce postoperative gastroesophageal reflux disease (GERD) and/or intrathoracic migration (ITM) incidence. Previous,mid-term Results of a prospective, comparative study evaluating posterior cruroplasty concomitant with LSG (group A 48 patients with simple vs. group B 48 reinforced with bioabsorbable mesh) confirmed the safety and effectiveness of simultaneous procedures. Present aim: to report the 60 months follow-up update, evaluating GERD, esophageal lesions ’ incidence and HH’s recurrence.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
This study describes changes in GERD symptoms in patients undergoing LSG and HHR.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
ConclusionHiatal repair with gastropexy is an acceptable treatment option for GERD after LSG but not very effective because of partial remission of symptoms.
Source: Obesity Surgery - Category: Surgery Source Type: research
Day-case surgery (DCS) is a hot topic in gastrointestinal surgery. DCS was primarily validated for inguinal hernia repair, cholecystectomy [1] and the treatment of gastroesophageal reflux disease [2, 3]. New indications for DCS in the field of gastrointestinal surgery have been recently described, such as laparoscopic sleeve gastrectomy (SG) [4], ileostomy closure [5], colectomy [6] and liver resection [7].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original Articles Source Type: research
This study aimed to assess practice patterns regarding concomitant HH repair (HHR) during laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The incidence of concomitant HHR with LSG or LRYGB was analyzed using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. One hundred thirty thousand, seven hundred seventy-two patients underwent RYGB (30.5%) and LSG (69.5%). Concomitant HHR was more common, despite less GERD, in SG patients compared to RYGB (21.0% vs 10.8%,p 
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionsOur results showed that primary LSG is a durable primary bariatric procedure with sustained weight loss and a high resolution of comorbidities at 10  years, but about half the patients had de novo GERD. The need for conversion to RYGB was 16.9% at 10 years.
Source: Obesity Surgery - Category: Surgery Source Type: research
ConclusionIn the medium term, GERD-HRQL improves following sleeve gastrectomy with meticulous hiatal assessment and repair of hiatal laxity and herniation.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Laparoscopic sleeve gastrectomy (LSG) is shown to be effective in achieving weight loss and improving related co-morbidities in patients who suffer from morbid obesity. Despite this, there is ongoing controversy regarding the potential of worsening and de novo gastrointestinal reflux disease (GERD) postoperatively. Current standard of care for worsening or new onset GERD status-post LSG indicates revision to laparoscopic roux-en-y gastric bypass (RYGB) in those patients not responsive to medical therapy.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
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