Esophageal Anatomy and Function in Laparoscopic Gastric Restrictive Bariatric Surgery: Implications for Patient Selection (original) (raw)

Background: The purpose of this study was to assess factors of clinical importance in morbidly obese patients having a laparoscopically adjustable gastric band (LAP-BAND®) implanted in order to achieve weight loss. Methods: Preoperative evaluation of hiatus hernia and esophageal (dys)motility were compared with the need for reoperation. Results are presented for the first 50 consecutive patients entered. Results: Nine of the first 50 patients required reoperation (18%). Five (10%) were for LAP-BAND slippage on the stomach. Of these five, reoperation was required in four of 12 (33%) with hiatus hernia (P = 0.0093); three of nine (33%) with a motility disorder (P = 0.025); and three of six (50%) with both hiatus hernia and a motility disorder (P = 0.0076). Conclusions: We identify two factors, hiatus hernia and esophageal dysmotility, which are associated, both independently as well as in combination, with reoperation for LAP-BAND® slippage. Both patients and their physicians should consider these data when considering the LAP-BAND® as possible therapy for morbid obesity.

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Authors and Affiliations

  1. Section Chief, Surgery, VAMC, Bronx, NY and Associate Professor, Department of Surgery, The Mount Sinai School of Medicine, CUNY, New York, NY, USA
    Robert J Greenstein MD, FACS
  2. Visiting Surgeon: Present address - Hadassah Hospital, Jerusalem, Israel
    A Nissan MD
  3. Clinical Associate Professor, Department of Medicine, The Mount Sinai School of Medicine CUNY, New York, NY, USA
    B Jaffin MD

Authors

  1. Robert J Greenstein MD, FACS
  2. A Nissan MD
  3. B Jaffin MD

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Greenstein, R.J., Nissan, A. & Jaffin, B. Esophageal Anatomy and Function in Laparoscopic Gastric Restrictive Bariatric Surgery: Implications for Patient Selection.OBES SURG 8, 199–206 (1998). https://doi.org/10.1381/096089298765554818

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