Treating Severe GERD and Obesity with a Sleeve Gastrectomy with Cardioplication and a Transit Bipartition
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Epidemiological data have demonstrated that obesity is an important risk factor for the development of gastroesophageal reflux disease (GERD). The proportion of subjects with GERD symptoms can be as high as 50% for BMI > 30. Although still controversial in the literature, there are several studies associating sleeve gastrectomy (SG) with an increase in GERD prevalence. The current video shows the technique of a SG with cardioplication associated with transit bipartition (TB) for the treatment of an obese patient with severe GERD.
Case Report and Management
A 46-year-old male presented with obesity and GERD symptoms for several years. His BMI was 37.8 kg/m2 with mainly central obesity and several obesity-related comorbidities, including hypertension, dyslipidemia, severe insulin resistance, and obstructive sleep apnea. After a diagnostic evaluation, the patient was submitted to a sleeve gastrectomy with a transit bipartition. He presented satisfactory weight loss, reaching a BMI of 26 and remission of all comorbidities and complete remission of GERD symptoms. The current follow-up period is 2.5 years and the patient did not present any weight regain or return of the GERD symptoms.
We presented a surgical alternative that is effective in both weight loss and remission of GERD. SG + TB is a potent intervention for metabolic syndrome and obesity. Furthermore, this alternative is capable of treating both obesity and GERD, in a simple way, avoiding mechanical restriction and the significant malabsorption related to excluded segments.
KeywordsMorbidity obesity GERD Bariatric surgery Sleeve gastrectomy Transit bipartition
Authors SS, CGA, and FCM were responsible for conception and design, and also performed drafting and critical revision of the manuscript.
All authors contributed to and have approved the final manuscript. All authors take public responsibility for its content.
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Conflict of Interest
The authors declare that they have no conflict of interest.
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