LAPAROSCOPIC SLEEVE GASTRECTOMY AS A REVISION FOR A FAILED LAPAROSCOPIC GASTRIC PLICATION (July 2019)

Case presentation

A 28 year-old-female patient with weight regain after failed laparoscopic gastric plication done by another surgeon one year ago.
Her last body mass index was calculated as 39.8 kg/m2..
Laparoscopic sleeve gastrectomy was planned as a redo surgery.
A plicated stomach with increased wall thickness of the greater curvature was seen. After adhesiolysis between the plicated part of stomach and the surrounding omental tissues plus removal of suture thread of the plication, laparoscopic sleeve gastrectomy was performed.
She was discharged on the 6th post-operative day with uneventful postoperative course.
At the postoperative 2nd month, her body mass index was recorded as 30 kg/m2.

Review of literature

Int J Surg Case Rep. 2013; 4(10): 872–874.
Published online 2013 Aug 3. doi: 10.1016/j.ijscr.2013.07.020
PMCID: PMC3785862
PMID: 23973898
Laparoscopic sleeve gastrectomy in management of weight regain after failed laparoscopic plication☆
Halil Coskun, Gokhan Cipe, Suleyman Bozkurt, Huseyin Kazim Bektasoglu, Mustafa Hasbahceci,⁎ and Mahmut Muslumanoglu

Abstract

NTRODUCTION
Weight regain after bariatric surgery remains a challenging problem with regard to its surgical management.

PRESENTATION OF CASE

A 30 year-old-female patient with weight regain after failed laparoscopic gastric plication and previous gastric banding was evaluated in a tertiary-care university setting. Her last body mass index was calculated as 40.4 kg/m2. Preoperative ultrasonography revealed cholelithiasis. Laparoscopic sleeve gastrectomy with cholecystectomy was planned as a redo surgery. A floopy and plicated stomach with increased wall thickness of the greater curvature was seen. After adhesiolysis between the plicated part of stomach and the surrounding omental tissues, concomitant laparoscopic sleeve gastrectomy and cholecystectomy were performed. She was discharged on the 4th post-operative day without any complaint. At the postoperative 3rd month, her body mass index was recorded as 24 kg/m2.

DISCUSSION

Redo surgery of morbid obesity after failed bariatric surgery is a technically demanding issue. Type of the surgical treatment should be decided by the attending surgeon based on the morphology of the remnant stomach caused by previous operations.

CONCLUSION

As a redo surgery after failed laparoscopic gastric plication and gastric banding procedures, laparoscopic sleeve gastrectomy may be regarded as a safe and feasible approach in experienced hands.

Keywords: Bariatric surgery, Sleeve gastrectomy, Gastric plication, Weight regain

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