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28.11.2016 | Original Scientific Report with Video | Ausgabe 4/2017

World Journal of Surgery 4/2017

Sleeve Gastrectomy Combined with the Simplified Hill Repair in the Treatment of Morbid Obesity and Gastro-esophageal Reflux Disease: Preliminary Results in 14 Patients

World Journal of Surgery > Ausgabe 4/2017
Daniel Gero, Lara Ribeiro-Parenti, Konstantinos Arapis, Jean-Pierre Marmuse
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s00268-016-3829-y) contains supplementary material, which is available to authorized users.
Presented as Poster communication International Federation for the Surgery of Obesity and Metabolic Disorders European Chapter Meeting (IFSO-EC) in Gotheborg, Sweden, 1–4 June 2016.



Our aim is to report our initial experience with a novel technique which addresses morbid obesity and gastro-esophageal reflux disease (GERD) simultaneously by combination of laparoscopic sleeve gastrectomy (LSG) and simplified laparoscopic Hill repair (sLHR).


Retrospective analysis of LSG+sLHR patients >5 months postoperatively includes demographics, GERD status, proton-pump inhibitor (PPI) use, body mass index (BMI), excess BMI loss (EBMIL), complications and GERD-Health Related Quality of Life (GERD-HRQL) questionnaire. LSG+sLHR surgical technique: posterior cruroplasty,  standard LSG, fixation of the esophagogastric junction to the median arcuate ligament.


Fourteen patients underwent LSG+sLHR [12 women and 2 men, mean (range) age 47 years (27–57), BMI 41 kg/m2 (35–65)]. Five patients had previous gastric banding (GB). All had symptomatic GERD confirmed by gastroscopy and/or upper-gastrointestinal contrast study, two with chronic cough, 10 took PPI daily. Twelve had hiatus hernia and two patulous cardia at surgical exploration. Associated interventions were three GB removals and one cholecystectomy. Postoperative complication was one surgical site infection. Follow-up of all patients at median 12.5 months (5–17) is as follows: symptomatic GERD 3/14 patients, chronic cough 0/14, daily PPI use in 1/14, mean EBMIL 68% (17–120), satisfaction 93%, mean GERD-HRQL score 3,28/50 (0–15), with 4 patients 0/50, occasional bloatedness in 2 patients and dysphagia not reported.


The novel technique which combines LSG with sLHR is feasible, safe and can be associated with GB removal. Preliminary results showed patient satisfaction, high remission rate of preexisting GERD, decrease in PPI use and unimpaired weight loss. Further evaluation is necessary in a controlled and staged manner to establish the technique’s real effectiveness.

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