Letter to the Editor Concerning: Kassir R, Lointier P, Breton C, Blanc P. Bariatric Surgery after Previous Antireflux Surgery Without Takedown of the Previous Fundoplication: a Prospective Study
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We read the article “Bariatric surgery after previous antireflux surgery without takedown of the previous fundoplication: a prospective study.” with special interest  since we also published on the same subject very recently . We congratulate the authors and would like to address a few points.
Unlike the authors’ work, all previous reports on gastric bypass in patients with previous anti-reflux surgery emphasized the absolute need to do “complete wrap unfolding” with the hypothesis that stapling over the fundoplication can create an obstructed/septated pouch. This hypothesis, ironically, resulted in many life-threatening complications as reviewed in our article . The first Nissen-preserving bariatric procedures were reported by Watson et al.  and Smith et al. recently  and the 5 cases in Kassir et al.’s report  provide further evidence against the misplaced dogma to do “complete wrap unfolding” during any bariatric procedure. Reports on bariatric...
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Conflict of Interest
The authors declare that they have no conflict of interest
- 1.Kassir R, Lointier P, Breton C, et al. Bariatric surgery after previous antireflux surgery without takedown of the previous fundoplication: a prospective study. Obes Surg. 2019:1–4. https://doi.org/10.1007/s11695-019-04180-0.