A634 Revisional surgery from RYGB to sleeve gastrectomy plus JJB and hiatus hernia repair
Mild Dumping syndrome is common but severe dumping syndrome is rare and needs revisional surgery after Roux-en-Y gastric bypass(RYGB).
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 . 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 after LRYGB.
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).
Gastroesophageal reflux disease (GERD) is common in the morbidly obese population, and hiatal hernias are encountered in 20% to 52% of patients. Primary surgical repair of hiatal hernias, in particular the paraesophageal type, is associated with a higher recurrence rate in obese patients. Concomitant weight loss surgery may be advisable. Combined sleeve gastrectomy and paraesophageal hiatal hernia repair is feasible but can induce or worsen preexisting GERD. A Roux-en-Y gastric bypass offers advantages of more pronounced excess weight loss and better symptom control, albeit with a potentially higher rate of morbidity compa...
ConclusionSynchronous VHR and BS in a bariatric unit is feasible with low recurrence rate. Laparoscopic VHR has lower complication rates than open, apart from seroma formation. Patients with diabetes have higher risk of infection.
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
ConclusionsThis video demonstrates the feasibility and safety of one-step laparoscopic conversion of vertical banded gastroplasty to sleeve gastrectomy.
ConclusionsRYGB may increase the risk of CDI hospitalization when compared to VSG and VHR controls. This data suggest VSG may be a better bariatric choice when post-surgical CDI risk is a concern.
Morbidly obese patients are predisposed to developing ventral hernias. Although the optimal timing of ventral hernia repair (VHR) and bariatric surgery is unclear, concurrent management remains common. The aim of this study was to assess the incidence of wound site occurrence in the setting of VHR during bariatric surgery.
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.