Skip to main content
SpringerLink
Log in

Laparoscopic Sleeve-Collis-Nissen Gastroplasty: a Safe Alternative for Morbidly Obese Patients with Gastroesophageal Reflux Disease

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Some studies have recently suggested that laparoscopic sleeve gastrectomy may exacerbate gastroesophageal reflux disease (GERD) symptoms or even increase the risk of “de novo” post-operative GERD. We herein describe and evaluate the initial response of an alternative technique of sleeve gastroplasty combined with Nissen fundoplication for morbidly obese patients who present significant GERD.

Methods

From January 2008 to December 2013, 122 morbidly obese patients underwent laparoscopic Sleeve-Collis-Nissen gastroplasty (LSCNG).

Results

The great majority of the patients were female (97.5 %), with a mean age of 42.4 years old (from 18 to 72). Hiatal hernia and use of proton pump inhibitors (PPIs) were presented in 54.9 and 92 %, respectively. The mean operative time was 91 ± 6 min. The mean hospitalization stay was 2 ± 0.3 days. Major complications including stenosis requiring endoscopic dilation and GI bleeding were observed in five patients (4.1 %). No leaks were observed. One-year follow-up showed a significant decrease in the prevalence of esophagitis (100 vs 13.6 %) and the use of PPIs (92 vs 13.6 %). The percentages of excess weight loss 1 and 3 years after the surgery were 64.4 ± 7.2 and 60.4 ± 8.1 %, respectively.

Conclusions

LSCNG is a novel, technically feasible surgery with a low incidence of procedure-related complications. However, further prospective studies are required to assess the real impact of this procedure on the improvement of GERD symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Dupree CE, Blair K, Steele SR, et al. Laparoscopic sleeve gastrectomy in patients with preexisting gastroesophageal reflux disease: a national analysis. JAMA Surg. 2014. doi:10.1001/jamasurg.2013.4323.

    PubMed  Google Scholar 

  2. Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg. 2011;254(3):410–20. doi:10.1097/SLA.0b013e31822c9dac. discussion 420–2.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Deitel M, Crosby RD, Gagner M. The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18(5):487–96. doi:10.1007/s11695-008-9471-5.

    Article  PubMed  Google Scholar 

  4. Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721–31. doi:10.1007/s11695-012-0616-1.

    Article  PubMed  Google Scholar 

  5. Kleidi E, Theodorou D, Albanopoulos K, et al. The effect of laparoscopic sleeve gastrectomy on the antireflux mechanism: can it be minimized? Surg Endosc. 2013;27(12):4625–30. doi:10.1007/s00464-013-3083-4.

    Article  PubMed  Google Scholar 

  6. Chiu S, Birch DW, Shi X, et al. Effect of sleeve gastrectomy on gastroesophageal reflux disease: a systematic review. Surg Obes Relat Dis. 2011;7(4):510–5. doi:10.1016/j.soard.2010.09.011.

    Article  PubMed  Google Scholar 

  7. Del Genio G, Tolone S, Limongelli P, et al. Sleeve gastrectomy and development of “de novo” gastroesophageal reflux. Obes Surg. 2014;24(1):71–7. doi:10.1007/s11695-013-1046-4.

    Article  PubMed  Google Scholar 

  8. Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18(10):1323–9. doi:10.1007/s11695-008-9551-6.

    Article  PubMed  Google Scholar 

  9. Gautier T, Sarcher T, Contival N, et al. Indications and mid-term results of conversion from sleeve gastrectomy to Roux-en-Y gastric bypass. Obes Surg. 2013;23(2):212–5. doi:10.1007/s11695-012-0782-1.

    Article  PubMed  Google Scholar 

  10. Khazzaka A, Sarkis R. Fundoplication combined with mediogastric plication. Surg Obes Relat Dis. 2013;9(3):398–403. doi:10.1016/j.soard.2011.08.019.

    Article  PubMed  Google Scholar 

  11. Fedenko V, Evdoshenko V. Antireflux sleeve gastroplasty: description of a novel technique. Obes Surg. 2007;17(6):820–4.

    Article  PubMed  Google Scholar 

  12. Lee WJ, Han ML, Ser KH et al. Laparoscopic Nissen fundoplication with gastric plication as a potential treatment of morbidly obese patients with GERD, first experience and results. Obes Surg. 2014;24:1447–52. doi:10.1007/s11695-014-1223-0.

  13. Diamantis T, Apostolou KG, Alexandrou A, et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2014;10(1):177–83. doi:10.1016/j.soard.2013.11.007.

    Article  PubMed  Google Scholar 

Download references

Conflict of Interest

Leonardo E. da Silva has no conflict of interest.

Maxley M. Alves has no conflict of interest.

Tanous K. El-Ajouz has no conflict of interest.

Paula C. P. Ribeiro has no conflict of interest.

Ruy J. Cruz Jr. has no conflict of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

This study was approved by the hospital ethical committee and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Author information

Authors and Affiliations

  1. Instituto de Cirurgia Metabólica, Obesidade e Aparelho Digestivo (ICAD), Rua 9 numero 130 ap 1802, Goiânia, GO, 74110-100, Brazil

    Leonardo Emilio da Silva, Maxley M. Alves & Paula C. P. Ribeiro

  2. Department of Anesthesiology, Unique Hospital, Goiânia, GO, Brazil

    Tanous Kalil El-Ajouz

  3. Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA

    Ruy J. Cruz Jr.

Authors
  1. Leonardo Emilio da Silva
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maxley M. Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tanous Kalil El-Ajouz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Paula C. P. Ribeiro
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ruy J. Cruz Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leonardo Emilio da Silva.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

da Silva, L.E., Alves, M.M., El-Ajouz, T.K. et al. Laparoscopic Sleeve-Collis-Nissen Gastroplasty: a Safe Alternative for Morbidly Obese Patients with Gastroesophageal Reflux Disease. OBES SURG 25, 1217–1222 (2015). https://doi.org/10.1007/s11695-014-1523-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-014-1523-4

Keywords

Search

Navigation