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.

Use of sleeve-customized self-expandable metal stents for the treatment of staple-line leakage after laparoscopic sleeve gastrectomy

2015 ◽  
Vol 81 (5) ◽  
pp. 1291-1294 ◽  
Author(s):  
Sigal Fishman ◽  
Mati Shnell ◽  
Nathan Gluck ◽  
Shmuel Meirsdorf ◽  
Subhi Abu-Abeid ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Staple Line ◽  
Metal Stents ◽  
Staple Line Leakage

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.

Outcomes of laparoscopic paraesophageal hernia repair in elderly and high-risk patients

Surgery ◽  
2006 ◽  
Vol 140 (4) ◽  
pp. 491-499 ◽  
Author(s):  
Noopur Gangopadhyay ◽  
Juan M. Perrone ◽  
Nathaniel J. Soper ◽  
Brent D. Matthews ◽  
J. Christopher Eagon ◽  
...  
Keyword(s):  
High Risk ◽  
Hernia Repair ◽  
Paraesophageal Hernia ◽  
Paraesophageal Hernia Repair ◽  
High Risk Patients ◽  
Risk Patients ◽  
Laparoscopic Paraesophageal Hernia Repair

Comparison of Staple-Line Leakage and Hemorrhage in Patients Undergoing Laparoscopic Sleeve Gastrectomy with or Without Seamguard

2011 ◽  
Vol 77 (12) ◽  
pp. 1665-1668 ◽  
Author(s):  
Todd E. Simon ◽  
Joshua A. Scott ◽  
Joel R. Brockmeyer ◽  
Robert C. Rice ◽  
James D. Frizzi ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Staple Line ◽  
Preoperative Evaluation ◽  
Conclusive Evidence ◽  
Staple Line Reinforcement ◽  
Number Of Patients ◽  
Significant Difference ◽  
Staple Line Leaks ◽  
Staple Line Leakage

Laparoscopic sleeve gastrectomy (LSG) has been recognized as a primary procedure for the surgical management of morbid obesity. Staple-line leaks and hemorrhage are two associated complications. Staple-line buttressing materials have been suggested to decrease these complications. When used during LSG, few published papers exist that compare the incidence of leak or hemorrhage to that of nonreinforced staple-lines. The purpose of this study was to compare the incidence of leak and hemorrhage in patients who did and did not receive reinforcement with Seamguard (W.L. Gore & Associates, Flagstaff, AZ). This is a retrospective analysis of patients undergoing LSG. All patients met National Institutes of Health criteria and each had an extensive preoperative evaluation. Data was collected from inpatient and outpatient medical records. Fifty-nine patients received reinforcement and 80 patients did not. There was no significant difference in mean body mass index, age, or gender make-up between the two groups. The overall incidence of leak was 3.60 per cent. The incidence was 3.39 per cent in patients who received reinforcement and 3.75 per cent in those who did not. This was not statistically significant. There was no incidence of staple-line hemorrhage in either group. There is no conclusive evidence that Seamguard reduces staple-line leakage or hemorrhage. Studies involving a larger number of patients are necessary before recommending staple-line reinforcement.

Is Staple LRE to Prevent Post-Operative Staple Line Leak and Haemorrhage after Laparoscopic Sleeve Gastrectomy

2021 ◽  
Vol 15 (11) ◽  
pp. 3028-3029
Author(s):  
Junaid Khan Lodhi ◽  
Aasim Malik ◽  
Saba Tahir Bokhari ◽  
Saima Amjad ◽  
Muhammad Zubair ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Staple Line ◽  
Operation Time ◽  
P Value ◽  
Staple Line Reinforcement ◽  
Postoperative Leak ◽  
Added Benefit ◽  
Staple Line Leakage ◽  
Group 2

Background: Staple line haemorrhage and leak are considered to be common complications of laparoscopic sleeve gastrectomy. Some strongly recommend staple line reinforcement to deal with these complications while some consider it non beneficial. Aim: To analyze if staple line reinforcement is essential to prevent staple line haemorrhage and leaks. Methods: This retrospective study was conducted in Surgical unit 1 Fatima Memorial Hospital. A total of 100 patients were selected and divided into two groups of 50 each. Group 1 had staple line reinforced while group 2 had no reinforcement at all. All patients were observed for 24-48 hours for post-operative bleeding and leak. Results: Staple line leakage was found to be 4% in patients with staple line reinforcement whereas it was 6% in patients without staple line reinforcement with a p value of 0.284 which was not significant. Likewise, staple line bleeding in both groups were 2% and 6% with p value of 0.129 which was also insignificant. Conclusion: There is no added benefit to reinforce the staple line to prevent postoperative leak or bleeding but reinforcement only prolongs the operation time. Keywords: Laparoscopic sleeve gastrectomy, leak, post-operative bleeding, staple line reinforcement

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