title: Treatment of morbid obesity and gastroesophageal reflux with hiatal hernia by Lap-Band.
abstract: BACKGROUND
  Esophageal reflux is common in obese patients. Hiatal hernia is considered a potential contraindication to placement of a Lap-Band.
  
  
  METHODS
  Esophageal investigation in patients who were candidates for a Lap-Band included clinical evaluation of symptoms (scoring system), endoscopic and radiologic evaluation, 24-h pH test, and stationary manometry. Patients with gastroesophageal reflux (GER) with or without hiatal hernia underwent the Lap-Band procedure.
  
  
  RESULTS
  GER was diagnosed in 12/40 morbidly obese patients, 11 of whom received a standard Lap-Band (3 patients were radiologically diagnosed with transient hiatal hernia). One patient with a large hiatal hernia underwent closure of the diaphragmatic esophageal hiatus, and the Lap-Band was positioned similarly to an Angelchik prosthesis. All but 1 patient who was lost at follow-up were symptom-free (range 1-24 months).
  
  
  CONCLUSIONS
  GER with or without hiatal hernia is not a contraindication for obese patients undergoing a Lap-Band procedure. It accomplishes by a single operation satisfactory treatment of these two disturbing diseases.
authors.affiliation: 1st Department of Surgery, University Federico II, Medical School, Naples, Italy. lapclub.na@endosphere.it
authors.forename: L
authors.initials: L
authors.lastname: Angrisani
authors.forename: P
authors.initials: P
authors.lastname: Iovino
authors.forename: M
authors.initials: M
authors.lastname: Lorenzo
authors.forename: T
authors.initials: T
authors.lastname: Santoro
authors.forename: F
authors.initials: F
authors.lastname: Sabbatini
authors.forename: E
authors.initials: E
authors.lastname: Claar
authors.forename: O
authors.initials: O
authors.lastname: Nicodemi
authors.forename: G
authors.initials: G
authors.lastname: Persico
authors.forename: B
authors.initials: B
authors.lastname: Tesauro
mesh_terms: D000328:Adult; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications / Q000601:surgery*; D015391:Gastroplasty / Q000379:methods*; D006551:Hernia, Hiatal / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*