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Sometimes the Best Solution Is Transit Bipartition: Video Case Report.

Midhat Abu Sneineh1, Se'bastien Strypstein2, Bruno Dillemans2

  • 1Department of Abdominal Surgery, Bariatric Unit, AZ St-Jan Hospital, 8000, Bruges, Belgium. midhat_1987@hotmail.com.

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Summary

Santoro's operation, a sleeve gastrectomy with transit bipartition, offers reduced complications and malnutrition compared to other bariatric surgeries. It addresses refractory reflux after sleeve gastrectomy, presenting a unique surgical case and technique.

Keywords:
Bariatric surgeryGastric bypassRedo bariatric surgerySantoro operationSleeve gastrectomyTransit bipartition

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Area of Science:

  • Bariatric Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Santoro's operation, a sleeve gastrectomy with transit bipartition, is a modification of the duodenal switch procedure.
  • It aims to minimize nutritional complications and allow endoscopic management by avoiding complete duodenal exclusion.

Observation:

  • Gastro-esophageal reflux disease (GERD) is a known complication of sleeve gastrectomy, sometimes requiring surgical intervention.
  • Potential causes of GERD post-sleeve gastrectomy include altered lower esophageal sphincter pressure and gastric compliance.

Findings:

  • Transit bipartition has demonstrated efficacy and safety, with benefits in reducing side effects and protein malnutrition compared to traditional bariatric procedures.
  • This report presents a unique surgical case and technique for managing complex cases, potentially related to refractory GERD after sleeve gastrectomy.

Implications:

  • Santoro's operation may offer an improved safety profile and reduced malnutrition in bariatric surgery.
  • Understanding the mechanisms of GERD post-sleeve gastrectomy is crucial for surgical technique refinement and patient management.