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Published on: September 22, 2023
Transoral antireflux plication: a new approach for refractory GERD after laparoscopic sleeve gastroplasty
Vismaya S Bachu1, Cameron Quon2, Anna H Lee2
1Department of Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA.
Background And Aims:
New-onset GERD is a common adverse event after laparoscopic sleeve gastrectomy (LSG), with limited treatment options beyond medical therapy or surgical conversion. This case study presents a minimally invasive endoscopic approach-transoral antireflux plication (TARP)-for managing post-LSG GERD.
Methods:
A 54-year-old woman with refractory GERD post-LSG underwent endoscopic sleeve revision and TARP. The procedure involved submucosal injection, mucosal incision, and full-thickness endoscopic suturing to reduce gastric volume and create an antireflux barrier.
Results:
A pH monitoring study 1 month postprocedure showed significant improvement in reflux parameters and symptom relief, independent of weight loss.
Conclusions:
TARP with endoscopic sleeve revision may offer a safe, minimally invasive alternative to surgery for post-LSG GERD. Further research is needed to confirm long-term efficacy and patient selection criteria.
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