Related Experiment Video
Updated: Dec 19, 2025
Author Spotlight: Recent Advancements in Reoperative Foregut Surgery
Published on: September 22, 2023
Incidence of de Novo Hiatal Hernia after Laparoscopic Sleeve Gastrectomy
Jorge Saba1,2,3, Magdalena Bravo4, Eugenio Rivas5
1Service of Bariatric and Metabolic Surgery, Indisa Clinic, Avenida Santa María 1810, 7520440, Santiago, Chile. doctor@jorgesaba.cl.
Purpose:
After laparoscopic sleeve gastrectomy (LSG), several studies have reported an increase in the incidence of gastroesophageal reflux (GERD). The etiopathogenesis of GERD post-LSG is multifactorial, and hiatal hernia (HH) is one of them. The primary objective was to measure the incidence of de novo HH post-LSG. The secondary objectives were to relate the presence of HH with GERD, the chronic use of proton pump inhibitors (PPI), and the time elapsed from LSG.
Materials And Methods:
A surgical evaluation of the crura after LSG was performed. A retrospective cohort study of 74 consecutive patients with history of LSG submitted to an intra-abdominal surgery that allowed the evaluation of the crura.
Results:
Of a total of 74 patients, 51 were included. At the time of surgery, 37 patients (72.5%) had a HH; 24 patients (47.1%) had GERD, and 23 patients (45.1%) were frequently using PPI. When patients with HH and those without HH were compared, GERD was observed in 56.8% versus 21.4% (p = 0.01) and frequent consumption on PPI was found in 54.1% versus 21.4% (p = 0.02). According to the data of LSG, with a follow-up of < 18 months, 60% presented HH; meanwhile, with a follow-up of > 18 months, 84.6% presented HH (p = 0.02).
Conclusions:
Patients submitted to LSG showed a high incidence of de novo HH. HH was associated with a higher incidence of GERD and PPI dependence. The longer the time elapsed from the LSG, the greater the incidence of HH.
