A162 Investigation of Laparoscopic Sleeve Gastrectomy with and without concurrent Paraesophageal Hiatal Hernia Repair utilizing the ACS MBSAQIP
We present a query of national bariatric surgery data investigating the efficacy of concurrent laparoscopic sleeve gastrectomy and paraesophageal hiatal hernia repair (LSGPEHR) as compared to laparoscopic sleeve gastrectomy (LSG).
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
We present a case of 60-year-old man with a body mass index of 45.3 kg/m2 with a large recurrent ventral hernia. We performed a lap sleeve gastrectomy with laparoendoscopic anterior component separation with IPOM. The operative steps included hernia contents reduction, conventional sleeve gastrectomy, anterior component separation on either side, intra-corporeal closure of hernia defect and placement of a composite mesh. Patient recovery was uneventful. Concomitant bariatric surgery with laparoendoscopic component separation with IPOM may be safe, but more studies are required.
This study aims to assess differences in practice patterns regarding concomitant HH repair during laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (LRYGB).
Laparoscopic Sleeve Gastrectomy (LSG) is now the most commonly performed procedure in the US according to the most recent ASMBS estimates with excellent short and long term outcomes. However, long term complications following LSG, including refractory GERD, weight gain and intrathoracic sleeve migration are commonly encountered in high volume bariatric centers. Intra-thoracic sleeve migration can result in gastric strangulation and should be repaired immediately. In our center we have developed an aggressive approach in identifying and repairing hiatal ernias intraoperatively in combination with sleeve gastrect...
We are presenting a 53 year old female with a BMI of 57. Past medical history includes OSA on CPAP, HTN, CHF, low back pain, osteoarthritis, IBS, bipolar disorder, seizure disorder and a left hepatic hemangioma that is relevant for this case. The patient had prior abdominal surgeries including laparoscopic cholecystectomy, appendectomy and 2 C-section s. She was evaluated for her morbid obesity and comorbidities and was deemed to be a good candidate for bariatric surgery. Her preoperative workout included an upper endoscopy that was normal without esophagitis. As a work up for an episode o...
ConclusionsLaparoscopic HH repair offers a safe and feasible approach in the management of persistent GERD after LSG in well-selected bariatric patients. Larger prospective studies are warranted to investigate the effectiveness of HH repair in this population as 22% of our patients did not demonstrate postoperative symptomatic improvement.
In conclusion, the recent publication of pH monitoring data and the new insights in the association between sleeve morphology and GERD control have led to a wider acceptance of LSG as bariatric procedure also in obese patients with GERD, as recently stated in the 5(th) International Consensus Conference on sleeve gastrectomy. PMID: 28428706 [PubMed - in process]
Abstract BACKGROUND: Laparoscopic sleeve gastrectomy has become a popular bariatric surgery in recent years. However, it has been linked to worsening or newly developed gastroesophageal reflux disease (GERD) in the postoperative period. OBJECTIVES: The purpose of this study is to determine the safety and effectiveness of anterior fundoplication sleeve gastrectomy in patients with reflux. SETTING: Academic hospital, United States. METHODS: We prospectively collected data on 31 sleeve gastrectomy patients who concurrently underwent anterior fundoplication between July 2014 and March 2016. Patients wer...
Gastro-esophageal acid reflux disease (GERD) is prevalent after Laparoscopic Sleeve Gastrectomy (LSG), a common bariatric surgical procedure worldwide. Some studies have suggested that concomitant hiatal hernia repair (HHR) during LSG reduces the risk of GERD, but that has not been substantiated. Little is known about the safety of adding a HHR in this setting. The present study aims to compare 30-day morbidity and mortality and length of hospital stay between patients undergoing LSG alone and those undergoing LSG with HHR.