Elizabeth Hechenbleikner, MD, Fatemeh Parvin-Nejad, BA, David Berler, MD, Daniel Herron, MD. Mount Sinai Hospital, Garlock Division of Surgery
This case highlights the challenges encountered during a delayed laparoscopic sleeve gastrectomy converison after band removal. Dense adhesions between the stomach and the liver as well as the spleen along with the former gastric plication obscure normal anatomic tissue planes. Important technical tips addressed during this procedure include: 1) careful adhesiolysis using predominantly sharp dissection around the liver and spleen, 2) minimizing the use of electrocautery to avoid underlying thermal injury to the stomach, 3) precise and complete release of the gastric plication from prior band placement, 4) identification of gastric plication sutures to help delineat anatomy, 5) avoidance of the use of stapling devices to release the gastric plication, and 6) routine use of upper endoscopy. In particular, identification and release of the gastric plication is a crucial step in this procedure as the integrity of the sleeve gastrectomy will be jeopardized if this is not done correctly.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88407
Program Number: V164
Presentation Session: Bariatrics Videos Session
Presentation Type: Video