Concurrent bariatric surgery and paraesophageal hernia repair: comparison of sleeve gastrectomy and Roux-en-Y gastric bypass

2018 ◽  
Vol 14 (1) ◽  
pp. 8-13 ◽  
Author(s):  
Amber L. Shada ◽  
Miloslawa Stem ◽  
Luke M. Funk ◽  
Jacob A. Greenberg ◽  
Anne O. Lidor
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Paraesophageal Hernia ◽  
Paraesophageal Hernia Repair

Comparison between Laparoscopic Paraesophageal Hernia Repair with Sleeve Gastrectomy and Paraesophageal Hernia Repair Alone in Morbidly Obese Patients

2009 ◽  
Vol 75 (7) ◽  
pp. 620-625 ◽  
Author(s):  
Aziz M. Merchant ◽  
Michael W. Cook ◽  
Jahnavi Srinivasan ◽  
S. Scott Davis ◽  
John F. Sweeney ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Gastric Emptying ◽  
Hernia Repair ◽  
Antireflux Surgery ◽  
Paraesophageal Hernia ◽  
Delayed Gastric Emptying ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Paraesophageal Hernia Repair

Treatment options for morbidly obese patients with complications from large paraesophageal hernias (PEH) are limited. Simple repair of the PEH has a high recurrence rate and may be associated with poor gastric function. We compared a series of patients who underwent repair of large PEH plus gastrostomy tube gastropexy (PEH-GT) with PEH plus sleeve gastrectomy (PEHSG). Retrospective review of patients undergoing PEH-SG and patients with PEH-GT was performed. We assessed symptoms of delayed gastric emptying and reflux postoperatively. In selected patients, gastric-emptying studies and upper gastrointestinal contrast studies were also obtained. All patients with large PEH were repaired laparoscopically with sac resection, primary crural closure using pledgeted sutures, and biologic patch onlay. SG for patients undergoing concomitant weight loss surgery (PEH-SG) was performed with linear endoscopic staplers and staple line reinforcement. Patients undergoing PEH repair alone had a gastrostomy tube gastropexy (PEH-GT). Patients had intraoperative endoscopic evaluation and postoperative contrast swallow studies. In a 12-month period, five patients underwent laparoscopic PEH-SG; two of five had previous antireflux surgery and one of five with a previous diagnosis of delayed gastric emptying. Postoperatively, two patients undergoing PEH-SG had readmission for dehydration and odynophagia. Six-month follow-up body mass index was 32 kg/m2 for the PEH-SG group with no hernia recurrence and complete resolution of gastroesophageal reflux disorder symptoms. Six patients underwent PEH-GT, one for acute incarceration and anemia and four with previous antireflux surgery. Follow up at 8 months demonstrated one recurrence, four of six had severe delayed gastric emptying and reflux, three of six had additional hospitalization for poor oral intake, and three of six underwent reoperation for delayed gastric emptying. There were no perforations, leaks, or deaths in either group. Combined laparoscopic PEH-SG is a clinically reasonable option for patients with morbid obesity with minimal additional risks and decreased incidence of delayed gastric emptying, reflux, and reoperation.

scholarly journals SIMULTANEOUS SURGERIES IN BARIATRIC SURGERY (LITERATURE REVIEW)

2021 ◽  
Author(s):  
Yuri V. Ivanov
Keyword(s):  
Bariatric Surgery ◽  
Morbid Obesity ◽  
Surgical Treatment ◽  
Hernia Repair ◽  
Paraesophageal Hernia ◽  
Ventral Hernia Repair ◽  
Anterior Abdominal Wall ◽  
Gallstone Disease ◽  
Paraesophageal Hernia Repair ◽  
Calculous Cholecystitis

Based on the available publications, the article presents an analysis of studies on the problem of simultaneous execution of cholecystectomy, ventral and paraesophageal hernia repair during bariatric intervention. If there is a clinical picture of chronic calculous cholecystitis, simultaneous cholecystectomy is justified and does not lead to a significant increase in the number of complications. In case of asymptomatic stone-bearing disease, the optimal tactic remains controversial, both surgical treatment and observation are possible. In the absence of gallstone disease, all patients after surgical correction of excess weight are shown to take ursodeoxycholic acid, while performing preventive cholecystectomy is not recommended. Simultaneous ventral hernia repair is justified only for small defects ( 10 cm) of the anterior abdominal wall. If a paraesophageal hernia is detected in patients with morbid obesity, bariatric surgery may be combined with cruroraphy.

scholarly journals Esophageal Perforation After Laparoscopic Sleeve Gastrectomy and Paraesophageal Hernia Repair Managed by Transhiatal Drainage

2019 ◽  
Vol 104 (9-10) ◽  
pp. 480-484
Author(s):  
Sunu Philip ◽  
Kerry Kole
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Perforation ◽  
Paraesophageal Hernia ◽  
Staple Line ◽  
Paraesophageal Hernia Repair ◽  
Risk Patients ◽  
Staple Line Leakage ◽  
Laparoscopic Assisted

Laparoscopic sleeve gastrectomy (SG) was first established as a 2-stage procedure in high-risk patients undergoing gastric bypass or biliary pancreatic diversion with duodenal switch. It has since become increasingly used as a primary bariatric procedure. The 2 significant postoperative complications after this procedure are anastomotic staple line leakage or bleeding. True esophageal leaks after sleeve gastrectomy are extremely uncommon. We present a case of contained esophageal perforation after a laparoscopic sleeve gastrectomy and paraesophageal hernia repair managed successfully with laparoscopic-assisted transhiatal drainage. We review the literature on the management of this uncommon but highly morbid complication in patients undergoing bariatric surgery.

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