- Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate exposure of the hiatus and the stomach. Currently used approaches utilize retractors that require additional incisions and prolong operative time.
- Sliding hiatus hernia (SHH) is a frequent condition associated with obesity . After Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), SHH may be asymptomatic, may predispose to gastroesophageal reflux disease (GERD) , and occasionally may trigger painful dysphagia. The pathophysiology of pain is thought to be related to the rubbing of the gastric staple line on the left diaphragmatic pillar, transmitted by the left phrenic nerve .
- For the purpose of building best practice guidelines, an international expert panel was surveyed in 2014 and compared with the 2011 Sleeve Gastrectomy Consensus and with survey data culled from a general surgeon audience.
- Gastroesophageal reflux disease (GERD) is a condition seen commonly in the bariatric surgery population. Although some operations, such as Roux-en-Y gastric bypass, are known to be associated with a reduced incidence of reflux postoperatively, the prevalence of GERD after laparoscopic sleeve gastrectomy (LSG) may be increased by 2.1% ~ 34.9% . In addition, it is still controversial for the treatment of medication-refractory GERD after LSG. Here, we report the surgical management of a patient, suffering from acid reflux, heartburn, and vomiting, with a modified laparoscopic Belsey (Mark IV) fundoplication 2 years after a successful LSG operative for obesity.
- Laparoscopic sleeve gastrectomy (LSG) has proved to be a safe and efficacious step or stand-alone surgical procedure for the treatment of morbid obesity. An increase in the body mass index and the accumulation of visceral fat are associated with a two- to threefold increased risk of developing reflux symptoms . Long-term complications appear to have a low incidence; however, in recent publications, gastroesophageal reflux disease (GERD) has been reported to occur in ≤27% of patients 6 years after the procedure.
- Laparoscopic sleeve gastrectomy (LSG) has become increasingly popular as a primary weight loss procedure in the United States . The adoption of single-incision techniques for common laparoscopic procedures has also been increasing . Although the theoretical benefits of decreased pain and increased speed of return to unrestricted function have yet to be scientifically proven, the concept of single-incision surgery appeals directly to patients interested in “less-invasive” and cosmetically pleasing surgery.