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Modified Sleeve Gastrectomy Combined with Laparoscopic Rossetti Fundoplication and Vascularization Assessment with Indocyanine Green

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Morbid obesity is a key risk factor for gastroesophageal reflux; the aim of this study is to describe the technique of modified laparoscopic Rossetti fundoplication to treat morbid obesity related to GERD.


This is a video/dynamic manuscript on operative technique. We present the case of a 38-year-old patient referred to our institution for morbid obesity (BMI 43 kg/m2) related to GERD symptoms with grade A esophagitis at the preoperative upper gastro intestinal endoscopy and in daily therapy with PPI since years. The patient was scheduled for a laparoscopic sleeve gastrectomy combined with Rossetti fundoplication.


Intraoperative and postoperative course were uneventful. One year later, the BMI is 27.9 kg/m2 and at clinical and endoscopic follow-up demonstrates absence of esophagitis and any PPI therapy is needed.


The modified sleeve gastrectomy combined with laparoscopic Rossetti fundoplication seems to be a safe, effective procedure and a suitable alternative to gastric bypass in obese patients with GERD.

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Correspondence to Giulia David.

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All procedures performed were in accordance with the ethical standards of the institutional and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Olmi, S., David, G., Cesana, G. et al. Modified Sleeve Gastrectomy Combined with Laparoscopic Rossetti Fundoplication and Vascularization Assessment with Indocyanine Green. OBES SURG 29, 3086–3088 (2019). https://doi.org/10.1007/s11695-019-03970-w

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  • Sleeve gastrectomy
  • Fundoplication
  • Gastroesophageal reflux
  • Bariatric surgery