Obesity is associated with the development of gastroesophageal reflux disease (GERD) and hiatal hernia (HH). This study aimed to assess practice patterns regarding concomitant HH repair (HHR) during laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). The incidence of concomitant HHR with LSG or LRYGB was analyzed using the 2015 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database. One hundred thirty thousand, seven hundred seventy-two patients underwent RYGB (30.5%) and LSG (69.5%). Concomitant HHR was more common, despite less GERD, in SG patients compared to RYGB (21.0% vs 10.8%, p < 0.0001; adjusted OR 2.14, 95% CI 2.06–2.22). This marked difference in the intraoperative management of HH during bariatric surgeries may hinder our ability to evaluate the long-term effects of bariatric surgery on GERD.
Hiatal hernia Bariatric surgery Sleeve gastrectomy Roux-en-Y gastric bypass Obesity
This is a preview of subscription content, log in to check access.
Compliance with Ethical Standards
For this retrospective study, formal consent is not required.
Does not apply to this retrospective study.
Conflicts of Interest
Dr. Docimo reports non-financial support from Boston Scientific, from null, outside the submitted work; Dr. Spaniolas reports non-financial support from Mallincktodt, grants from Merck, outside the submitted work; Dr. Pryor reports personal fees from Ethicon, personal fees from Medtronic, personal fees from Stryker, and from Gore, and grants from Baranova and from Obalon, outside the submitted work; Drs. Bates and Talamini have no conflicts of interest. Uzma Rahmana has no conflicts of interest.
Katz PO, Gerson LB, Vela MF. Guidelines for the diagnosis and management of gastroesophageal reflux disease. Am J Gastroenterol. 2013;108:308–28.CrossRefGoogle Scholar
Roman S, Pandolfino JE. Environmental–life style related factors. Best Pract Res Clin Gastroenterol. 2010;24(6):847–59.CrossRefGoogle Scholar
Che F, Nguyen B, Cohen A, et al. Prevalence of hiatal hernia in the morbidly obese. SOARD. 2013;9(6):920–4.Google Scholar
Nadaleto Herbella FAM, Patti MG. Gastroesophageal reflux disease in the obese: pathophysiology and treatment. Surgery. 2015;159(2):475–486BF.CrossRefGoogle Scholar
Sippey M, Kasten KR, Chapman WH, et al. 30-day readmissions after sleeve gastrectomy versus Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;12(5):991–6.CrossRefGoogle Scholar
Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett’s esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017 Apr;13(4):568–74.CrossRefGoogle Scholar
Daes J, Jimenez ME, Said N, et al. Laparoscopic sleeve gastrectomy: symptoms of gastroesophageal reflux can be reduced by changes in surgical technique. Obes Surg. 2012;22(12):1874–9.CrossRefGoogle Scholar
Ece I, Yilmaz H, Acar F, et al. A new algorithm to reduce the incidence of gastroesophageal reflux symptoms after laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(6):1460–5.CrossRefGoogle Scholar
Redondo R, Albertson H, Gandsas A. Hiatal hernia repair after sleeve gastrectomy: a case series. Surg Obes Relat Dis. 2017;13(10):S186.Google Scholar
Madalosso CA, Gurski RR, Callegari-Jacques SM, et al. The impact of gastric bypass on gastroesophageal reflux disease in morbidly obese patients. Ann Surg. 2016;263(1):110–6.CrossRefGoogle Scholar