title: Laparoscopic median gastrectomy for stenosis following sleeve gastrectomy.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) has become an established primary bariatric procedure. Gastric stenosis after LSG has been reported in a few studies and often occurs at the level of incisura or midbody because of a technical operative error and could be associated with a leak. This can be managed by endoscopic dilations or revision surgery. The objective of this study is to describe a novel technique to deal with sleeve stenosis and its outcome.
  
  
  METHODS
  Two patients presented with sleeve stenosis after LSG and underwent a novel technique. The patients were followed up for 18 months.
  
  
  RESULTS
  We describe a novel technique of laparoscopic median gastrectomy in 2 patients that involved resection of the stenotic segment followed by a hand-sewn, gastrogastric, end-to-end anastomosis. Both patients had successfully recovered from stenosis related symptoms, although one required an endoscopic dilation of the anastomosis.
  
  
  CONCLUSIONS
  Laparoscopic median gastrectomy is a feasible and effective option in patients who have failed conservative management of stenosis after LSG and in whom there is a desire to avoid seromyotomy or conversion to gastric bypass.
authors.affiliation: Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom.
authors.forename: Ramya
authors.initials: R
authors.lastname: Kalaiselvan
authors.affiliation: Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom. Electronic address: bammori@btinternet.com.
authors.forename: Basil J
authors.initials: BJ
authors.lastname: Ammori
mesh_terms: D000328:Adult; D003251:Constriction, Pathologic; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012086:Reoperation; D013270:Stomach / Q000601:surgery; D013272:Stomach Diseases / Q000209:etiology / Q000601:surgery*
keywords: Median gastrectomy; Sleeve gastrectomy; Sleeve stenosis