Gastric Banding Research Today is a free monthly online journal that collates and summarizes the latest research about Gastric Banding, including details on laparoscopic gastric banding, stomach stapling, gastric bypass, risks, diet. | ||||||||
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Crural Repair Permits Morbidly Obese Patients with Not Large Hiatal Hernia to Choose Laparoscopic Adjustable Banding as a Bariatric Surgical Treatment.Frezza EE, Barton A, Wachtel MS Division of General Surgery, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, MS 8312, Lubbock, TX, 79430, USA, eldo.frezza@ttuhsc.edu. BACKGROUND: Hiatal hernia, present radiologically in about 50% of patients desiring bariatric surgery, has been thought a contraindication to laparoscopic adjustable gastric banding (LAGB). Posited was the notion that adding crural repair to LAGB would enable this procedure to be offered to patients desiring bariatric surgery who had hiatal hernias. METHODS: After obtaining IRB approval, charts of all patients who underwent simultaneous crural repair and LAGB from June 2003 to January 2006 were reviewed. All patients were evaluated with the DeMeester score and the GERD-HQRL score pre- and postoperatively. Statistical analyses included the Mann-Whitney U test and the Chi-squared test. RESULTS: Twenty-one patients underwent laparoscopic procedure with crural repair; none required conversion to an open procedure. There were no mortalities. Two complications, a wound infection at the level of the port, and a case postoperative dysphagia resolved with therapy. Eighty-six percent of the patients ceased regular intake of heartburn medicines, P < .01. Median percent excess weight loss was 45% at 1 year and 55% at 2 years. The modified DeMeester score fell to 0-2 postoperatively (P < .01). Two years after the procedure, symptoms were less, as assessed by GERD-HQRL scores (P < .01). CONCLUSION: Crural repair permits LAGB to be safely and effectively performed in patients with hiatal hernia. Published 4 March 2008 in Obes Surg.
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