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Obesity Surgery
Published in: Obesity Surgery 5/2008

01-05-2008 | Research Article

Crural Repair Permits Morbidly Obese Patients with Not Large Hiatal Hernia to Choose Laparoscopic Adjustable Banding as a Bariatric Surgical Treatment

Authors: Eldo E. Frezza, Audrae Barton, Mitchell S. Wachtel

Published in: Obesity Surgery | Issue 5/2008

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Abstract

Background

Hiatal hernia, present radiologically in about 50% of patients desiring bariatric surgery, has been thought a contraindication to laparoscopic adjustable gastric banding (LAGB). Posited was the notion that adding crural repair to LAGB would enable this procedure to be offered to patients desiring bariatric surgery who had hiatal hernias.

Methods

After obtaining IRB approval, charts of all patients who underwent simultaneous crural repair and LAGB from June 2003 to January 2006 were reviewed. All patients were evaluated with the DeMeester score and the GERD-HQRL score pre- and postoperatively. Statistical analyses included the Mann–Whitney U test and the Chi-squared test.

Results

Twenty-one patients underwent laparoscopic procedure with crural repair; none required conversion to an open procedure. There were no mortalities. Two complications, a wound infection at the level of the port, and a case postoperative dysphagia resolved with therapy. Eighty-six percent of the patients ceased regular intake of heartburn medicines, P < .01. Median percent excess weight loss was 45% at 1 year and 55% at 2 years. The modified DeMeester score fell to 0–2 postoperatively (P < .01). Two years after the procedure, symptoms were less, as assessed by GERD-HQRL scores (P < .01).

Conclusion

Crural repair permits LAGB to be safely and effectively performed in patients with hiatal hernia.
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Metadata
Title
Crural Repair Permits Morbidly Obese Patients with Not Large Hiatal Hernia to Choose Laparoscopic Adjustable Banding as a Bariatric Surgical Treatment
Authors
Eldo E. Frezza
Audrae Barton
Mitchell S. Wachtel
Publication date
01-05-2008
Publisher
Springer-Verlag
Published in
Obesity Surgery / Issue 5/2008
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-007-9339-0

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