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Published on: June 11, 2012
Relevance of Posterior Gastric Vessel in Bariatric Surgery
Prakhar Gupta1, Shivanshu Misra1, S Saravana Kumar1
1Department of Bariatric Surgery, GEM Hospital and Research Center, Coimbatore, Tamil Nadu, India.
Insights
The posterior gastric vessel is frequently seen in bariatric surgery. Managing this vessel through division or lateralization is crucial for effective gastric sleeve and pouch creation.
Area of Science:
- Gastroenterology
- Surgical Anatomy
- Bariatric Surgery
Background:
- The posterior gastric vessel, with variable anatomy, is frequently encountered during upper abdominal surgeries.
- Its anatomical description and significance in bariatric procedures remain under-documented.
Purpose of the Study:
- To investigate the incidence and management of the posterior gastric vessel in bariatric surgery.
- To assess the vessel's role in achieving optimal surgical configurations for sleeve gastrectomy and gastric bypass.
Main Methods:
- Retrospective review of 100 bariatric surgery video recordings.
- Documentation of the presence, origin, and course of the posterior gastric vessel.
- Analysis of surgical techniques employed for vessel management (division or lateralization).
Main Results:
- The posterior gastric vessel was identified in 88% of reviewed cases.
- In sleeve gastrectomy (LSG), the vessel was present in 54/63 cases and division was necessary for fundic mobilization.
- In Roux-en-Y gastric bypass (RYGB), the vessel was present in 34/37 cases, requiring lateralization in 31 and division in 3.
Conclusions:
- The posterior gastric vessel is a common finding in bariatric surgery, necessitating specific management strategies.
- Division or lateralization of the posterior gastric vessel is essential for adequate fundic mobilization, crucial for successful LSG and RYGB outcomes.
Abstract:
Posterior gastric vessel is commonly encountered (4-99%) during surgery of the stomach, spleen, and pancreas. Due to high variations in its origin, and course, it has not been unanimously described in literature. Its significance in bariatric surgery is largely neglected. We reviewed videos of 100 bariatric surgery cases done in our institute. This vessel was noted in 88 cases. We could identify the vessel in 54/63 LSG cases and all cases required division to free the fundus. It was identified in 34/37 RYGB cases. Thirty-one cases required lateralization while 3 cases required division due to more medial origin of the vessel. Its division or lateralization facilitates adequate mobilization of fundus to achieve the ideal configuration of sleeve in LSG and pouch in LRYGB.
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