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Modified Sleeve Gastrectomy Combined with Laparoscopic Rossetti Fundoplication and Vascularization Assessment with
Stefano Olmi1, Giulia David2, Giovanni Cesana1
1Department of Surgery, S.I.C.OB. (Italian Society of Bariatric Surgery) Referral Center for Bariatric Surgery, San Donato Group, Policlinico San Marco, 24040 Zingonia-Osio Sotto, Bergamo, Italy.
Aim:
Morbid obesity is a key risk factor for gastroesophageal reflux; the aim of this study is to describe the technique of modified laparoscopic Rossetti fundoplication to treat morbid obesity related to GERD.
Methods:
This is a video/dynamic manuscript on operative technique. We present the case of a 38-year-old patient referred to our institution for morbid obesity (BMI 43 kg/m2) related to GERD symptoms with grade A esophagitis at the preoperative upper gastro intestinal endoscopy and in daily therapy with PPI since years. The patient was scheduled for a laparoscopic sleeve gastrectomy combined with Rossetti fundoplication.
Results:
Intraoperative and postoperative course were uneventful. One year later, the BMI is 27.9 kg/m2 and at clinical and endoscopic follow-up demonstrates absence of esophagitis and any PPI therapy is needed.
Conclusion:
The modified sleeve gastrectomy combined with laparoscopic Rossetti fundoplication seems to be a safe, effective procedure and a suitable alternative to gastric bypass in obese patients with GERD.
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