title: Laparoscopic gastropexy relieves symptoms of obstructed gastric volvulus in highoperative risk patients.
abstract: BACKGROUND
  Operative repair of obstructive gastric volvulus is challenging. In high-operative risk patients with obstructive gastric volvulus, we perform laparoscopic reduction of gastric volvulus and anterior abdominal wall sutured gastropexy. This case series reports our experience with this operation.
  
  
  METHODS
  We reviewed the charts of all patients who presented with obstructive gastric volvulus and underwent laparoscopic gastropexy between 2007 and 2013.
  
  
  RESULTS
  Eleven patients underwent laparoscopic gastropexy. Median age was 83 years (50 to 92). Six patients presented with chronic obstruction; 5 presented with acute obstruction. Median postoperative hospitalization was 2 days (1 to 39). Two patients required reoperation for displaced gastrostomy tubes. At median follow-up of 3 months (2 weeks to 57 months), all patients remained free of gastric obstructive symptoms and recurrent episodes of volvulus. Only 1 patient received nutrition via gastrostomy tube.
  
  
  CONCLUSIONS
  Laparoscopic gastropexy can treat obstructed gastric volvulus in highoperative risk patients. Because of associated morbidity, gastrostomy tubes should be placed selectively.
authors.affiliation: Department of surgery, University of Washington, 1959 NE Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195, USA. Electronic address: rby2@uw.edu.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Yates
authors.affiliation: Department of surgery, University of Washington, 1959 NE Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195, USA.
authors.forename: Marcelo W
authors.initials: MW
authors.lastname: Hinojosa
authors.affiliation: Department of surgery, University of Washington, 1959 NE Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Wright
authors.affiliation: Department of surgery, University of Washington, 1959 NE Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195, USA.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Pellegrini
authors.affiliation: Department of surgery, University of Washington, 1959 NE Pacific Street, Suite BB-487, PO Box 356410, Seattle, WA 98195, USA.
authors.forename: Brant K
authors.initials: BK
authors.lastname: Oelschlager
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D017219:Gastric Outlet Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D059485:Gastropexy / Q000379:methods*; D006801:Humans; D015994:Incidence; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013277:Stomach Volvulus / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D014861:Washington / Q000453:epidemiology
keywords: Gastric outlet obstruction; Gastric volvulus; Gastropexy; Paraesophageal hernia; Tube gastrostomy