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

  • Mehmet Ali YerdelEmail author
  • İsmail Çalıkoğlu
  • Görkem Özgen
Letter to the Editor

Dear Editor

We read the article “Bariatric surgery after previous antireflux surgery without takedown of the previous fundoplication: a prospective study.” with special interest [1] since we also published on the same subject very recently [2]. 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 [2]. The first Nissen-preserving bariatric procedures were reported by Watson et al. [3] and Smith et al. recently [4] and the 5 cases in Kassir et al.’s report [1] provide further evidence against the misplaced dogma to do “complete wrap unfolding” during any bariatric procedure. Reports on bariatric...


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest


  1. 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.
  2. 2.
    Şen O, Çalıkoğlu İ, Özgen G, et al. Sleeve gastrectomy in patients with previous antireflux surgery. Preliminary results of the “no-touch to posterior wrap” technique. Surg Obes Relat Dis. 2019;15(10):1668–1674. Scholar
  3. 3.
    Watson MD, Mehaffey JH, Schirmer BD, et al. Roux-en-Y gastric bypass following nişsen fundoplication: Higher risk same reward. Obes Surg. 2017;27:2398–403.CrossRefGoogle Scholar
  4. 4.
    Smith CR, Gardner JT, Vaughn LH, et al. Nissen fundoplication-preserving laparoscopic sleeve gastrectomy. Am Surg. 2019;85:173–6.PubMedGoogle Scholar
  5. 5.
    Nguyen SQ, Grams J, Tong W, et al. Laparoscopic Roux-en-Y gastric bypass after previous Nissen fundoplication. Surg Obes Relat Dis. 2009;5:280–2.CrossRefGoogle Scholar
  6. 6.
    Yerdel MA, Türkçapar AG, Roslin MS. Emergency Roux-en-Y gastric bypass to treat “stenosis+leak” combination after sleeve gastrectomy in a super-super obese individual. Surg Obes Relat Dis. 2016;12:e35–7.CrossRefGoogle Scholar
  7. 7.
    Holmberg D, Santoni G, Xie S, et al. Gastric bypass surgery in the treatment of gastro-oesophageal reflux symptoms. Aliment Pharmacol Ther. 2019;50:159–66.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.İstanbul Bariatrics, Obesity and Advanced Laparoscopy CenterİstanbulTurkey

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