Adel Alhaj Saleh, MD, MRCS, Amir H Aryaie, MD, FACS. Texas Tech University Health Sciences Center
Case Background
- A 44 year-old female with morbid obesity (BMI of 41 kg/m2 ) with multiple comorbidities including gastroparesis and history of gastric stimulator insertion.
- She underwent multiple unsuccessful trials of medical weight loss.
- After all the preoperative work up she was offered laparoscopic sleeve gastrectomy with removal of gastric stimulation device with the subcutaneous piece as well.
Medical and Surgical History
- Morbid obesity
- Depression
- HTN
- DM II
- Gastroparesis
- GERD
- OSA
- 14 abdominal procedures including repair of incisional hernia and insertion of gastric stimulator for gastroparesis
Preoperative EGD
- Mild esophagitis and gastritis
- Biopsies obtained showed no abnormalities
The patient was then planned to
- Laparoscopic Removal of Gastric Stimulator and Sleeve Gastrectomy with injection of Botox at the pylorus
Post-operative Course
- Discharged after an uneventful postoperative recovery tolerating bariatric diet.
- 2 and 6-week clinic follow up – no nausea/vomiting/food intolerance
In Conclusion
- Laparoscopic removal of gastric stimulator in obese patients and conversion to gastric sleeve is a feasible option
- Injection of Botox at the pylorus will be helpful in gastric emptying and control of symptoms in perioperative period.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 96049
Program Number: V388
Presentation Session: Video Loop Day 4
Presentation Type: VideoLoop