Michael J Mullan, Colin D Botkin, Krista M Hardy, Ashley S Vergis. Victoria General Hospital
Narrowing at the angularis is a recognised technical error of laparoscopic sleeve gastrectomy. We present a multimedia video of the correction of this error in a patient with type 1 diabetes mellitus.
Eight months prior the patient had undergone sleeve gastrectomy. From time of operation, the patient described dysphagia. Post operatively calorie intake was severely restricted, as the patient’s diet had never advanced beyond soft foods. Further, the patient experienced extreme rapid weight-loss of 115lbs over 8 months. Investigations (gastroscopy, GI contrast study) suggested a twisting or narrowing of the sleeve at the angularis.
At time of re-gastroscopy with combined laparoscopy, it was apparent there was a narrowing at the angularis. This was corrected by making a gastrotomy across the narrowed waist of the sleeve and suturing the gastrotomy in the opposite direction to widen the narrowed area.
Six weeks post procedure the patient reports marked improvement in dysphagia and oral intake. In addition, the patient’s weight has stabilised.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 79720
Program Number: V207
Presentation Session: Video Loop
Presentation Type: VideoLoop