Crural Repair Permits Morbidly Obese Patients with Not Large Hiatal Hernia to Choose Laparoscopic Adjustable Banding as a Bariatric Surgical Treatment

Abstract Background The effect of laparoscopic sleeve gastrectomy (LSG) on gastroesophageal reflux disease (GERD) is controversial. Although concomitant hiatal hernia repair (HHR) at the time of LSG is common and advocated by many, there are few data on the outcomes of GERD symptoms in these patients. The aim of this study was to evaluate the effect of concomitant HHR on GERD symptoms in morbidly obese patients undergoing LSG. Aim of the Work To analyse the impact of hiatal hernia repair (HHR) on gastro-oesophageal reflux disease (GERD) in morbidly obese patients with hiatus hernia undergoing laparoscopic sleeve gastrectomy (LSG). Patients and Methods This is a retrospective cohart study. We collected the data of Patients who underwent lap sleeve gastrectomy with cruroplsty in the same operation in the period between July 2018 and July 2019. Results Before surgery, symptomatic GERD was present in 14 patients (70%), and HH was diagnosed In 20 patients (100%), HH was diagnosed pre-operatively. The mean follow-up was 6 months. GERD remission occurred in 18 patients (90%). In the remaining 2 patients, antireflux medications were diminished, with complete control of symptoms. HH recurrences developed in 1 patient (10%). "De novo" GERD symptoms developed in 22.9% of the patients undergoing SG alone compared with 0% of patients undergoing SG plus HHR. Conclusion SG with HHR is feasible and safe, providing good management of GERD in obese patients with reflux symptoms. Small hiatal defects could be underdiagnosed at preoperative endoscopy and/or upper gastrointestinal contrast study. Thus, a careful examination of the crura is always recommended intraoperatively.

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Clinical Utility of Endoscopy and Barium Swallow X-Ray in the Diagnosis of Sliding Hiatal Hernia in Morbidly Obese Patients: A Study Before and After Gastric Bypass

Obesity Surgery ◽

10.1007/s11695-009-9971-y ◽

2009 ◽

Vol 20 (6) ◽

pp. 702-708 ◽

Cited By ~ 32

Author(s):

Fernando Fornari ◽

Richard Ricachenevsky Gurski ◽

Daniel Navarini ◽

Victor Thiesen ◽

Luis Henrique Barbosa Mestriner ◽

...

Keyword(s):

Gastric Bypass ◽

Hiatal Hernia ◽

Clinical Utility ◽

Barium Swallow ◽

Morbidly Obese ◽

Obese Patients ◽

X Ray ◽

Before And After ◽

Sliding Hiatal Hernia

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Acute paraoesophageal hiatal hernia following laparoscopic sleeve gastrectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20205378 ◽

2020 ◽

Vol 7 (12) ◽

pp. 4177

Author(s):

Omar M. Alobaid ◽

Abdullah S. Alzahrani ◽

Bander I. Ali

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Hiatal Hernia ◽

Independent Risk Factor ◽

Morbidly Obese ◽

Obese Patients ◽

Significant Weight Loss ◽

Operative Endoscopy

Anti-obesity surgery is the most effective therapy available for significant weight loss in patients with morbid obesity. Obesity in consider a major independent risk factor for Hiatal hernia (HH) and it is present in about 37%-50% of morbidly obese patients undergoing bariatric surgery.1,2,3 It might be overlooked or under looked especially if the patient was asymptomatic and no pre-operative endoscopy or radiological workup. Denovo closure of the hiatal defect in case of an intraoperative finding of HH strongly recommended preventing such acute postoperative complications. Herein we report a rare and acute post laparoscopic sleeve gastrectomy with gastric herniation were uneventfully diagnosed and interfered early to prevent a catastrophic outcome.

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Feasibility of Laparoscopic Management of Hiatal Hernia and/or Gastroesophageal Reflux Disease with Laparoscopic Sleeve Gastrectomy or Greater Curvature Plication in Morbidly Obese Patients

Trends in Medical Research ◽

10.3923/tmr.2016.54.61 ◽

2016 ◽

Vol 11 (2) ◽

pp. 54-61

Author(s):

Ayman M. Elwan ◽

Mohammed A. Abomera ◽

Almetwaly R. Ibrahim ◽

Nagah S. Atwa ◽

Gaber M. Bakheet ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Laparoscopic Sleeve Gastrectomy ◽

Hiatal Hernia ◽

Reflux Disease ◽

Morbidly Obese ◽

Obese Patients ◽

Greater Curvature ◽

Greater Curvature Plication

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Laparoscopic management of large hiatal hernia: mesh method with the use of ProGrip mesh versus standard crural repair

Surgical Endoscopy ◽

10.1007/s00464-018-6087-2 ◽

2018 ◽

Vol 32 (8) ◽

pp. 3592-3598 ◽

Cited By ~ 6

Author(s):

V. V. Ilyashenko ◽

Viktor V. Grubnyk ◽

V. V. Grubnik

Keyword(s):

Hiatal Hernia ◽

Large Hiatal Hernia ◽

Laparoscopic Management ◽

Hernia Mesh ◽

Mesh Method ◽

Crural Repair

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Sleeve gastrectomy and crural repair in obese patients with gastroesophageal reflux disease and/or hiatal hernia

Surgery for Obesity and Related Diseases ◽

10.1016/j.soard.2012.06.003 ◽

2013 ◽

Vol 9 (3) ◽

pp. 356-361 ◽

Cited By ~ 132

Author(s):

Emanuele Soricelli ◽

Angelo Iossa ◽

Giovanni Casella ◽

Francesca Abbatini ◽

Benedetto Calì ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Hiatal Hernia ◽

Reflux Disease ◽

Obese Patients ◽

Crural Repair

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PS01.048: LAPAROSCOPIC ANTIREFLUX SURGERY IN MORBIDLY OBESE PATIENTS

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.048 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 63-63

Author(s):

Marcin Migaczewski ◽

Mateusz Rubinkiewicz ◽

Michał Pędziwiatr ◽

Piotr Major ◽

Jadwiga Dworak ◽

...

Keyword(s):

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

De Novo ◽

Morbidly Obese ◽

Obese Patients ◽

Gerd Symptoms ◽

Crural Repair

Abstract Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been proved to be effective bariatric procedure for the treatment of morbidly obese patients with gastroesophageal reflux disease (GERD). In contrast, the indication for laparoscopic sleeve gastrectomy (LSG) in these group of patients is still not clear. LSG with simultaneous crural repair it can be a new, safe and effective therapautic approach. Methods A total of 60 obese patients with GERD operated on in 2016–2018 were included in the study. 20 patients were qualified for LRYBG. In the rest LSG was performed, of which half with simultaneous crural repair. Results GERD symptoms complete control was observed in 18/20 (90%) patients after LRYGB and 17/20 (85%) after LSG with simultaneous crural repair. The same effect occurred only in 8/20 patients direct after simple LSG. ‘De novo’ GERD symptoms developed in 10% of the patients undergoing alone LSG during 12 months follow up. Conclusion Laparoscopic Roux-en-Y gastric bypass (LRYGB) is still effective bariatric procedure for the treatment of morbidly obese patients with gastroesophageal reflux disease (GERD). Doubts remain in the situation of young patients without diabetes. If we additionally deal with a large hiatal hernia, the qualification for LRYGB remains debatable. In this situation, it is worth considering LSG. Simple sleeve gastrectomy not only does not guarantee a good anti-reflux effect, but it can also produce de-novo GERD. Laparoscopic simultanous crurolasty in the time of LSG, represents a valuable option for the treatment of morbid obesity with gastroesophageal reflux disease Disclosure All authors have declared no conflicts of interest.

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