Article Data

  • Views 1227
  • Dowloads 157

Case Reports

Open Access

Intraoperative gastroscopy during laparoscopic sleeve gastrectomy after gastric band surgery with unrecognized hiatal hernia—a case report

  • Miklós Siptár1,*,
  • György Tizedes2
  • Bálint Nagy3
  • Szilárd Rendeki3
  • Sándor Márton4

1Department of Anesthesiology and Intensive Therapy, Intensive Care Units, University of Pécs, Medical School, 7624 Pécs, Hungary

2DaVinci Private Clinic, 7635 Pécs, Hungary

3Department of Anesthesiology and Intensive Therapy, Intensive Care Units and University of Pécs, Medical School, Medical Skills Education and Innovation Centre, University of Pécs, Medical School, 7624 Pécs, Hungary

4Department of Anaesthesology and Intensive Therapy, Department of Obstetric Anesthesiology, University of Pécs, Medical School, 7624 Pécs, Hungary

DOI: 10.22514/sv.2023.093 Vol.19,Issue 5,September 2023 pp.254-257

Submitted: 13 October 2022 Accepted: 11 January 2023

Published: 08 September 2023

*Corresponding Author(s): Miklós Siptár E-mail: siptarmiklos@gmail.com

Abstract

Obesity is the civilizational disease of our era, and often leads to comorbidity, hypertension, diabetes and obstructive sleep apnea. Contemporary non-surgical treatment for obesity is frequently inefficient, resulting in the increased prominence of surgical procedures, specifically, laparoscopic sleeve gastrectomy (LSG). In our case report, we present a case in which LSG was not feasible in reference to the traditional surgical technique due to severe hiatal hernia (HH), which inexplicably went undetected during preoperative examinations, however, with the help of intraoperative gastroscopy, the problem was effectively solved. The patient, a middle-aged Caucasian male, underwent removal of a gastric band due to gastric band migration, and was presented for LSG due to repeated weight gain. During the operation, the insertion of the bougie proved unsuccessful after several attempts. Through intraoperative gastroscopy, a severe HH was discovered. The endoscope was inserted into the compromised passageway leading into the stomach, effectively substituting the role of bougie used in the traditional surgical procedure. Unexpected difficulty or inability to insert a bougie is rare in consideration of LSG, however, in this case, surgery could not have been performed in the conventional manner. During intraoperative gastroscopy, the gastroscope is inserted into the stomach using visual control, and effectively substitutes the bougie function. The likelihood of rare, yet severe, life-threatening complications from the insertion of a bougie is reduced and surgery can be performed in the traditional sense. We have no knowledge of cases in which a HH prevents the conventional surgical technique. However, in extreme cases in which the traditional non-surgical technique and other types of surgery are deemed unsuitable, intraoperative gastroscopy provides a simple and safe solution.


Keywords

Bariatric surgery; Gastrectomy; Gastroesophageal reflux; Hernia; Hiatal; Gastroscopy; Comorbidity; Sleep apnea; Obstructive


Cite and Share

Miklós Siptár,György Tizedes,Bálint Nagy,Szilárd Rendeki,Sándor Márton. Intraoperative gastroscopy during laparoscopic sleeve gastrectomy after gastric band surgery with unrecognized hiatal hernia—a case report. Signa Vitae. 2023. 19(5);254-257.

References

[1] Koliaki C, Liatis S, Kokkinos A. Obesity and cardiovascular disease: revisiting an old relationship. Metabolism. 2019; 92: 98–107.

[2] Rurik I, Apor P, Barna M, Barna I, Bedros J R, Kempler P, et al. Therapy and prevention of obesity: nutrition, physical activity and medical treatment. Orvosi Hetilap. 2021; 162: 323–335. (In Hungarian)

[3] Carter R, Watenpaugh DE. Obesity and obstructive sleep apnea: or is it OSA and obesity? Pathophysiology. 2008; 15: 71–77.

[4] Stasi C, Milani S. Functions of ghrelin in brain, gut and liver. CNS & Neurological Disorders—Drug Targets. 2016; 15: 956–963.

[5] Ambrogi MD, Volpe S, Tamanini C. Ghrelin: central and peripheral effects of a novel peptydil hormone. Medical Science Monitor. 2003; 9: RA217–224.

[6] Benaiges D, Goday A, Ramon JM, Hernandez E, Pera M, Cano JF. Laparoscopic sleeve gastrectomy and laparoscopic gastric bypass are equally effective for reduction of cardiovascular risk in severely obese patients at one year of follow-up. Surgery for Obesity and Related Diseases. 2011; 7: 575–580.

[7] Wölnerhanssen B K, Peterli R, Hurme S, Bueter M, Helmiö M, Juuti A, et al. Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: 5-year outcomes of merged data from two randomized clinical trials (SLEEVEPASS and SM-BOSS). British Journal of Surgery. 2021; 108: 49–57.

[8] Che F, Nguyen B, Cohen A, Nguyen NT. Prevalence of hiatal hernia in the morbidly obese. Surgery for Obesity and Related Diseases. 2013; 9: 920–924.

[9] Şen O, Sekmen Ü, Türkçapar AG. The effect of laparoscopic sleeve gastrectomy with concomitant hiatal hernia repair on gastroesophageal reflux disease. Surgical Laparoscopy, Endoscopy & Percutaneous Techniques. 2022; 32: 449–452.

[10] Khan M, Mukherjee AJ. Hiatal hernia and morbid obesity—‘Roux-en-Y gastric bypass’ the one step solution. Journal of Surgical Case Reports. 2019; 2019: rjz189.

[11] Lovece A, Rouvelas I, Hayami M, Lindblad M, Tsekrekos A. Cervical esophageal perforation caused by the use of bougie during laparoscopic sleeve gastrectomy: a case report and review of the literature. BMC Surgery. 2020; 20: 9.

[12] Isik A, First D, Peker K, Sayar I, Idiz O, Soytürk M. A case report of esophageal perforation: complication of nasogastric tube placement. American Journal of Case Reports. 2014; 15: 168–171.


Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top