Reinforcement of the esophageal hiatus using ligamentum teres during sleeve gastrectomy: Outcomes regarding gastroesophageal reflux disease and hiatal hernia

Title : Reinforcement of the esophageal hiatus using ligamentum teres during sleeve gastrectomy: Outcomes regarding gastroesophageal reflux disease and hiatal hernia

Abstract:

Background: Laparoscopic sleeve gastrectomy (LSG) is a surgery that involves the removal of 75–80% of the stomach. It offers benefits like less postoperative pain and better recovery compared to open surgery, but it also carries the risk of developing gastroesophageal reflux disease (GERD) and hiatus hernia.

Patients and Methods: This retrospective study included a group of patients who underwent LSG, divided into two groups: Group A, which contained 30 patients who received LSG without ligamentum teres reinforcement (LTR), and Group B, with 30 patients, who underwent LSG with the additional LTR procedure.

Results: Group B experienced significantly fewer reflux symptoms during follow-up at 3, 9, and 18 months (p < 0.05). Additionally, Group B had a lower incidence of endoscopic reflux at 6 and 18 months (3.3% vs. 26.7% and 6.7% vs. 30.0%). Hiatus hernia size was significantly smaller in Group B (1.2 cm vs. 2.5 cm, p < 0.001).

Conclusion: Incorporating LTR during LSG may reduce postoperative GERD. The small sample size and retrospective design suggest the need for larger studies to confirm LTR’s long-term benefits as an adjunctive technique in bariatric surgery.

Biography:

Andrew Wanees is an experienced surgical doctor with over seven years of postgraduate training in General and Upper Gastrointestinal Surgery. He holds Full GMC Registration, MRCS qualification, and a Master’s degree in General Surgery, and is currently preparing for the FRCS examination. His clinical focus includes Bariatric Surgery, Upper GI malignancies, and emergency surgical care. he gained significant operative experience in both open and laparoscopic procedures, managing a wide range of bariatric and metabolic conditions including obesity-related complications, hiatal hernias, and complex revisional surgeries. He has a strong academic background, with multiple peer-reviewed publications on GERD, hiatus hernia repair, and bariatric surgical outcomes. he also completed the Harvard Medical School Clinical Scholars Research Training Program, enhancing his expertise in clinical research and evidence-based practice. he is Passionate about teaching, he holds a Train the Trainer certificate and has participated in undergraduate medical education and mentoring of junior doctors. His commitment to quality improvement is evident through his leadership in clinical audits targeting peri-operative safety and enhanced recovery. he is dedicated to advancing patient care through clinical excellence, research, and innovation, embodying the core values of the NHS.