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World Journal of Surgery

, Volume 41, Issue 4, pp 1035–1039 | Cite as

Sleeve Gastrectomy Combined with the Simplified Hill Repair in the Treatment of Morbid Obesity and Gastro-esophageal Reflux Disease: Preliminary Results in 14 Patients

  • Daniel GeroEmail author
  • Lara Ribeiro-Parenti
  • Konstantinos Arapis
  • Jean-Pierre Marmuse
Original Scientific Report with Video

Abstract

Background

Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR).

Methods

Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire. LSG+sLHR surgical technique: posterior cruroplasty,  standard LSG, fixation of the esophagogastric junction to the median arcuate ligament.

Results

Fourteen patients underwent LSG+sLHR [12 women and 2 men, mean (range) age 47 years (27–57), BMI 41 kg/m2 (35–65)]. Five patients had previous gastric banding (GB). All had symptomatic GERD confirmed by gastroscopy and/or upper-gastrointestinal contrast study, two with chronic cough, 10 took PPI daily. Twelve had hiatus hernia and two patulous cardia at surgical exploration. Associated interventions were three GB removals and one cholecystectomy. Postoperative complication was one surgical site infection. Follow-up of all patients at median 12.5 months (5–17) is as follows: symptomatic GERD 3/14 patients, chronic cough 0/14, daily PPI use in 1/14, mean EBMIL 68% (17–120), satisfaction 93%, mean GERD-HRQL score 3,28/50 (0–15), with 4 patients 0/50, occasional bloatedness in 2 patients and dysphagia not reported.

Conclusion

The novel technique which combines LSG with sLHR is feasible, safe and can be associated with GB removal. Preliminary results showed patient satisfaction, high remission rate of preexisting GERD, decrease in PPI use and unimpaired weight loss. Further evaluation is necessary in a controlled and staged manner to establish the technique’s real effectiveness.

Keywords

Hiatus Hernia Laparoscopic Sleeve Gastrectomy Lower Esophageal Sphincter Symptomatic GERD Erosive Esophagitis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgements

We are grateful to Mr Iván Eln for his precious contribution to the line art figure.

Compliance with ethical standards

Conflict of interest

Daniel Gero, Lara Ribeiro-Parenti, Konstantinos Arapis and Jean-Pierre Marmuse have no conflicts of interest or financial ties to disclose.

Supplementary material

Supplementary material 1 (AVI 185405 kb)

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Copyright information

© Société Internationale de Chirurgie 2016

Authors and Affiliations

  1. 1.Department of General and Digestive SurgeryUniversity Hospital Bichat – Claude-BernardParisFrance

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