Gastropexy after sleeve gastrectomy

Abstract

Background As the gastrocolic, gastrophrenic, gastrosplenic, and posterior gastric attachments are cut during laparoscopic sleeve gastrectomy (LSG), it increases the possibility of turning, twisting, or folding. In some cases, the fixation of the stomach will keep it in the correct position. Gastric twist can be suspected after surgery in those complaining of any degree of obstructive symptoms in the postoperative course. The objective of our study was to evaluate the value of gastropexy after LSG to the pancreatic fascia and its effect on intraoperative and postoperative morbidities. Patients and methods This prospective randomized study was conducted in Kasr El Ainy Hospital from May 2018 to November 2018. A total of 40 patients were subdivided into two groups. Group A included cases with LSG, whereas group B included cases with LSG with sleeve reattachment to the pancreatic fascia. Assessments of intraoperative twisting, bleeding, time consumed, postoperative vomiting, epigastric pain, gastrografin meal, and upper gastrointestinal endoscopy were done. Results A statistically significant difference regarding vomiting (P=0.003), epigastric pain (P=0.035), and operative time (P<0.001) was noticed between both groups. Conclusion Adding pancreatic attachment to the procedure posed no harm and did not increase any surgical morbidity. It reduced postoperative gastric pain and vomiting.