The Results of Hiatal Hernia not Amended During Gastric Banding – A Case Report and the Conclusions Stemming from it
Journal Title: Journal of Obesity and Bariatrics - Year 2016, Vol 3, Issue 2
Abstract
Introduction: Hiatal hernia is frequent in patients undergoing bariatric surgery [1].There is evidence that laparoscopic gastric banding is associated with deterioration of GERD, however, the treatment of a hiatal hernia accidentally discovered during a LGB is still under debate. We would like to use the current case report to shed some light upon the decision not to close a hiatal hernia discovered accidentally during Lap band, and its grave consequences. Patient description: A 36 old female, with a known LGB, was admitted to the Urology ward due to suspected nephrolithiasis and Left flank pain. Deterioration in her status and worsening of the LUQ pain has led to a CT with subsequent drain insertion due to a suspected effusion. A follow up CT showed the stomach in the left hemithorax, with the drain inserted in the upper border of the stomach. The patient was taken to the OR, and there a multidisciplinary team of general and cardiothoracic surgeons operated upon her. In the operation a left thoracotomy was done to enable the reduction of the stomach back to the abdomen and a thorough drainage of the left chest. After that, in a formal laparotomy a sleeve gastrectomy was done due to necrosis of the greater curvature. An esophagostomy was performed to enable diversion of esophageal content from the stomach. Discussion and conclusions: Many changes have occurred in thebariatric field since the 1990’s when hiatal hernia was considered a contraindication for LAGB. But, a change of paradigm has occurred, and just like our patient has shown, not operating upon a hiatal hernia during LAGB is extremely dangerous for the patient. From this stems only one conclusion - If one encounters a hiatal band during a LAGB procedure, be it a primary or revisional one, one has to fix this defect or else endanger his patient unnecessarily
Authors and Affiliations
Zvi Perry
Keywords
Related Articles
- EP ID EP205490
- DOI 10.13188/2377-9284.1000020
- Views 76
- Downloads 0
The Impacts of Childhood and Adolescent Obesity on Quality of Life
Obesity is important and its affects are not only limited to adults and medical conditions, but also may affect children and adolescents and may have overarching effects on social parameters. Programs to prevent the nega...
Revisional Bariatric Surgery
Background: To elucidate percent excess body weight loss (%EBWL) gained from revisional surgery and to determine resolution of comorbid conditions given the obesity epidemic.Methods: All patients undergoing revisional ba...
An Anatomical Point to Start Transection in Laparoscopic Sleeve Gastrectomy
Introduction: Laparoscopic Sleeve Gastrectomy (LSG) has become a preferred primary bariatric surgical approach. However, some technical aspects still lack standardization, including the distance from the pylorus at which...
Micro RNAs as Biomarkers of Bariatric Surgery Outcome and Putative Regulators of Hepatokines Selectively after Gastric Bypass, but not Sleeve Gastrectomy
The obesity prevalence is increasing worldwide, resulting in more bariatric surgeries interventions being performed. However, the success of surgical approaches in treating obesity and its co-morbidities varies between t...
Laparoscopic Revision of Vertical Banded Gastroplasty to Sleeve Gastrectomy for Gastric Outlet Obstruction: Early Experience in Cohort of 18 Patients
Introduction: The long-term effectiveness of Vertical Banded Gastroplasty (VBG) is limited due to development of complications related to gastric outlet obstruction at the band site. Surgical reversal or conversion to Ro...