Obesity surgery · 2007
Antireflux sleeve gastroplasty: description of a novel technique.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Fedenko Vadim, Evdoshenko Vladimir
Аннотация
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.
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.