title: Stomach intestinal pylorus sparing surgery (SIPS) with laparoscopic fundoplication (LF): a new approach to gastroesophageal reflux disease (GERD) in the setting of morbid obesity.
abstract: The increase in the prevalence of obesity and gastroesophageal reflux disease (GERD) has paralleled one another. Laparoscopic fundoplication (LF) (Nissen or Toupet) is a minimally invasive form of anti-reflux surgery. The duodenal switch is a highly effective weight loss surgery with a proven record of long term weight loss success. However, fundoplication alone does not give satisfactory results when used for GERD in morbidly obese patients. Here we present a novel approach combining stomach intestinal pylorus sparing surgery (SIPS) with LF for morbidly obese patients with GERD. The data from patients who underwent the SIPS procedure along with LF in past year was retrospectively analyzed. The variables collected were age, sex, height, weight, intra-operative and post-operative complications, length of stay, operative time, and estimated blood loss. All revisions were excluded. Descriptive statistics such as mean and standard deviation were used to analyze the data. The total sample size of the study was 5 patients, with a mean age of 59.6 ± 16.4 years, a mean weight of 292.1 ± 73.6 lbs., and a mean body mass index (BMI) of 43.4 ± 6.3. Weight loss patterns were the same as those without LF. All the 5 patients had resolution or improvement in their GERD symptoms within 6 months. SIPS with LF provides substantial and sustained weight loss and GERD resolution. Long term follow ups and further study on this novel surgical technique is recommended.
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Hinali
authors.initials: H
authors.lastname: Zaveri
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Amit
authors.initials: A
authors.lastname: Surve
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Christina
authors.initials: C
authors.lastname: Richards
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Walter
authors.initials: W
authors.lastname: Medlin
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: LeGrand
authors.initials: L
authors.lastname: Belnap
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Cottam
authors.affiliation: Bariatric Medicine Institute, 1046 East 100 South, Salt Lake City, UT 84102 USA.
authors.forename: Austin
authors.initials: A
authors.lastname: Cottam
keywords: Duodenal switch; Fundoplication; GERD; Obesity; Reflux; Weight loss