Michel Gagner, MD, FRCSC, FACS, FASMBS, Maxime Lapointe-Gagner. Clinique Michel Gagner MD, Inc.
Gastroparesis, defined as a delay in gastric empting without clear obstruction, is increasing in incidence mainly due to a recent diabetes epidemic. The use of laparoscopic sleeve gastrectomy alone to treat gastroparesis is still controversial, as results have been inconsistent. This video is presenting a technique that combines two known gestures increasing gastric emptying. On one side a pyloroplasty, where the pylorus is opened longitudinally and closed transversely, with laparoscopic hand-sewn techniques, and afterwards a laparoscopic sleeve gastrectomy is added concomitantly, which is known to decrease gastric empting time in obese subjects by 2 fold. We are presenting a severe case of gastroparesis, in a young woman with type-1 diabetes in which a gastrostomy was needed to feed her and decompress the stomach. The previous history is also important for the use of a per oral endoscopic pyloromyotomy (POP) technique that failed. Her preoperative gastric emptying test showed 96% retention after 1.5 hours. After 3 months a repeat test, showed near complete emptying at 51 minutes. This technique may have a higher percentage of success, and be synergistic, when combining two surgical gestures known to increase gastric empting time. It also may provide a correction for failed POP procedures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 92124
Program Number: V004
Presentation Session: Foregut I
Presentation Type: Video