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The visualization of gastro-esophageal junction vascular supply during a laparoscopic sleeve gastrectomy. Role of a new device

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Abstract

Leaks arising at the level of gastro-esophageal junction remain a major complication in patients who undergo a laparoscopic sleeve gastrectomy. Besides technical pitfalls, these fistulas are mainly attributable to tissue ischemia following the preparation of the gastric sleeve, explained by the irregular vascularization often present in the area of the gastro-esophageal junction. This video presentation shows how, the utilization of a new model of bougie can be of help in preventing a leak, allowing a better visualization of the particular vascular anatomy present at the level of the gastro-esophageal junction area. Currently, 25/334 (18 F–7 M) (7.4%) patients, who underwent a laparoscopic sleeve gastrectomy at our institution, were operated on using this new model of bougie. No leaks have been so far reported.

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Authors and Affiliations

  1. Advanced Biomedical Sciences Department, AOU “Federico II”, “Federico II” University, Via S. Pansini 5 Building 12, 80131, Naples, Italy

    Mario Musella, Marco Milone, Paolo Bianco & Francesco Milone

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  1. Mario Musella
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  2. Marco Milone
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  3. Paolo Bianco
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  4. Francesco Milone
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Corresponding author

Correspondence to Mario Musella.

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Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

A tested gastric double lumen tube currently available on the market was used. It has to be remarked that all LSG procedures performed by authors, and involving human participants, were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

An informed consent, according to the Italian Society of Bariatric and Metabolic Surgery (SICOB) guidelines, was obtained from all patients who underwent a LSG procedure performed by anyone of the authors of this study during these years.

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Supplementary material 2 (DOC 29 kb)

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Musella, M., Milone, M., Bianco, P. et al. The visualization of gastro-esophageal junction vascular supply during a laparoscopic sleeve gastrectomy. Role of a new device. Updates Surg 69, 541–544 (2017). https://doi.org/10.1007/s13304-017-0479-z

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  • DOI: https://doi.org/10.1007/s13304-017-0479-z

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