The Nissen-Sleeve: Early Postoperative Complications

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Laparoscopic sleeve gastrectomy (LSG) can lead to gastroesophageal reflux disease (GERD).
• The Nissen Sleeve (NS) is a modification aimed at mitigating reflux post-LSG.
• Early outcomes of NS require evaluation.

Purpose of the Study:

• To assess the safety and early postoperative complications of the Nissen Sleeve (NS) technique.
• To evaluate the efficacy of NS in managing preoperative GERD symptoms in obese patients.

Main Methods:

• Retrospective review of prospectively collected data from December 2019 to August 2020.
• Inclusion of morbidly obese patients undergoing NS with concurrent hiatal hernia repair.
• Analysis of early postoperative complications (within 30 days) and GERD symptom resolution.

Main Results:

• 28 NS procedures were performed, all with hiatal hernias (2-6 cm).
• Significant reduction in GERD symptoms: 25/28 patients achieved complete resolution, others improved.
• Early complications included 2 reinterventions (7.1%) and 3 cases of transient dysphagia (10.7%), managed conservatively with endoscopic dilatation.

Conclusions:

• Nissen Sleeve (NS) appears to be a safe bariatric procedure with an acceptable early complication rate.
• NS is effective for treating obesity and preoperative GERD symptoms.
• Long-term data is insufficient to determine if NS prevents de novo GERD after LSG.