• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Management Options for Symptomatic Stenosis Following Sleeve Gastrectomy in the Morbidly Obese

Management Options for Symptomatic Stenosis Following Sleeve Gastrectomy in the Morbidly Obese

Amit Parikh, DO, Joshua B Alley, MD, Richard M Peterson, MD MPH, Michael C Harnisch, MD, Jason M Pfluke, MD, Donovan N Tapper, MD, Stephen J Fenton, MD. San Antonio Military Medical Center, University of Texas Health Sciences Center at San Antonio

Objective: The laparoscopic vertical sleeve gastrectomy (LSG) is increasingly being used as a weight loss procedure. Little published data exist regarding the management of patients who develop a symptomatic stenosis. The purpose of this study was to determine the incidence of clinically symptomatic stenosis at our institution, identify factors that contribute to their formation, and present our management algorithm.

Methods: A retrospective review was performed of patients who underwent a LSG for morbid obesity between October 2008 – September 2010. All patients diagnosed with a clinically significant stenosis were included as well as patients transferred to our facility for specific treatment of sleeve stenosis.

Results: During this period, 186 patients underwent a LSG: 82% were female with a mean age of 49 years and mean pre-operative BMI of 43.1 kg/m². Six (3%) patients were diagnosed with a clinically symptomatic stenosis requiring intervention. All patients were female with a mean age of 40 years (28 – 54) and mean pre-operative BMI of 41 kg/m². All six patients underwent LSG over a 36 Fr. bougie using tissue reinforced staplers. Three patients had a portion of the staple line imbricated with a running 3-0 PDS suture. Upon suspicion of stenosis, all six patients underwent a contrast study with four (67%) demonstrating a focal narrowing of the sleeve. Endoscopy confirmed a short-segment stenosis in the mid-body of the sleeve of all six patients. The mean time from surgery to the initial endoscopic intervention was 47 days (26 – 150) and the mean time after the first intervention to tolerate a solid diet was 45 days (27 – 66). The mean number of endoscopic dilatations required was 2 (1 – 3) with a median balloon size of 18 mm. Endoscopic management was successful in all six patients. Two additional patients were referred to our institution for management of sleeve stenosis after undergoing LSG at another facility. The mean time to transfer was 28.5 days (21 – 36). The mean age was 35 years (33 – 37) with a mean pre-operative BMI of 40 kg/m². One surgery was complicated by a large staple line hematoma, and another by a staple line leak on POD 1 requiring an open exploration with oversew of the leak using permanent braided suture. Upon transfer, both underwent a contrast study that demonstrated minimal passage of contrast through a long segment of stenosis. Both underwent multiple endoscopic dilation procedures, followed by endoluminal stenting and ultimately required laparoscopic conversion to Roux-en-Y gastric bypass. The mean time from the initial surgery to the surgical revision was 77 days (65 – 89) and the mean time after the first intervention to tolerate a solid diet was 82.5 days (73 – 92).

Conclusion: Clinically significant short-segment stenoses following sleeve gastrectomy may be successfully treated with endoscopic balloon dilatation. Long-segment stenoses are less likely to respond to endoscopic techniques, and may ultimately require conversion to Roux-en-Y gastric bypass.


Session: SS09
Program Number: S043

2,387

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals