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Outcomes of Laparoscopic Hiatal Hernia Repair in Nine Bariatric Patients with Prior Sleeve Gastrectomy

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) may exacerbate gastroesophageal reflux disease (GERD) in patients with a hiatal hernia (HH). Surgical repair may be needed, however prior LSG precludes standard HH repair with fundoplication.

Methods

We retrospectively reviewed our experience with bariatric patients with prior LSG undergoing laparoscopic HH repair from August 2010 to July 2016. Patient demographics and outcomes including mortality, length of stay (LOS), readmission rates, reoperation, and complications were described. A validated 13-point questionnaire was used to determine symptomatic relief, weight loss, and overall satisfaction.

Results

A total of nine consecutive patients with prior LSG underwent HH repair and were included in the analysis. Repair was performed using Bio-A Gore® mesh (W.L Gore Inc., Newark, DE) in six (66.7%) cases and posterior cruroplasty in three (33.3%) patients. Heartburn was significantly decreased at 1 year (1.4 ± 0.9 vs. 2.6 ± 0.9, p = 0.031), and 78% of patients reported some degree of symptomatic relief after HH repair.

Conclusions

Laparoscopic HH repair offers a safe and feasible approach in the management of persistent GERD after LSG in well-selected bariatric patients. Larger prospective studies are warranted to investigate the effectiveness of HH repair in this population as 22% of our patients did not demonstrate postoperative symptomatic improvement.

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Authors and Affiliations

  1. Department of Surgery, Providence Hospital and Medical Centers, Michigan State University College of Human Medicine, 16001 W Nine Mile Rd, Southfield, MI, 48075, USA

    Francisco Igor B. Macedo, Mia Mowzoon, Vijay K. Mittal & Mubashir Sabir

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  1. Francisco Igor B. Macedo
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  2. Mia Mowzoon
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  3. Vijay K. Mittal
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  4. Mubashir Sabir
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Corresponding author

Correspondence to Francisco Igor B. Macedo.

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The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed Consent Statement

The Institutional Review Board (IRB) approval for this study was obtained by, waiving the need for informed consent.

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Macedo, F.I.B., Mowzoon, M., Mittal, V.K. et al. Outcomes of Laparoscopic Hiatal Hernia Repair in Nine Bariatric Patients with Prior Sleeve Gastrectomy. OBES SURG 27, 2768–2772 (2017). https://doi.org/10.1007/s11695-017-2880-6

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  • DOI: https://doi.org/10.1007/s11695-017-2880-6

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