Laparoscopic Ligamentum Teres cardiopexy to the rescue; an old procedure with a new use in managing reflux after sleeve gastrectomy.
American journal of surgery
BACKGROUND: Severe reflux after sleeve-gastrectomy (SG) often requires conversion to Roux-en-Y-Gastric Bypass (RYGB). We performed laparoscopic Ligamentum Teres Cardiopexy (LLTC) as an alternative operation.
MATERIALS & METHODS: Ten patients had LLTC between June 2019-June 2020. Pre-operative work-up included Barium swallow, upper endoscopy with pH monitoring. The percent excess body mass index (%EBMI) loss before LLTC was 70 ± 0.2%.
RESULTS: Pre-operative DeMeester score was 69 ± 50 (normal = 14.72). All patients underwent repair of hiatal hernia and gastric plication in addition to LLTC. The average operative-time was 110 ± 26 min. The follow up was 7 ± 3 months. Eight patients had resolution of their reflux. Two patients resumed medication for recurrent mild reflux.
CONCLUSION: LLTC is a safe technique and may be considered a rescue operation in lieu of conversion to RYGB in managing severe reflux after SG. Long term results are needed to confirm its durable effectiveness.
Hawasli A, Foster R, Lew D, Peck L. Laparoscopic Ligamentum Teres cardiopexy to the rescue; an old procedure with a new use in managing reflux after sleeve gastrectomy. Am J Surg. 2021 Mar;221(3):602-605. doi: 10.1016/j.amjsurg.2020.12.036. Epub 2020 Dec 25. PMID: 33384153.