title: Laparoscopic management of severe reflux after sleeve gastrectomy using the LINX®system: Technique and one year follow up case report.
abstract: BACKGROUND
  Management of severe reflux after sleeve gastrectomy (SG) usually requires converting to Roux-en-y gastric bypass (RYGB). We present a case of managing this problem using the LINX®system.
  
  
  METHODS
  In February 2015, we performed a laparoscopic placement of LINX®system to treat severe reflux after sleeve gastrectomy on a 25-year-old female. The operative time was 47min. There were no intra or postoperative complications. The hospital stay was one day. The postoperative UGI showed no reflux. Ten days after surgery her Quality of life score (QOL) changed from 64/75 to 7/75 after the LINX®placement. One year later the patient continued to enjoy no reflux and stayed off medication.
  
  
  CONCLUSIONS
  Reflux after sleeve gastrectomy is usually managed by conversion to RYGB by most surgeons. This case report opens the door for an alternative management of this problem while maintaining the original sleeve gastrectomy. This technique is reasonably easy to perform in comparison to the conversion to RYGB with less potential post-operative complications. A one year follow up showed good control of reflux without medication.
  
  
  CONCLUSIONS
  Laparoscopic placement of the LINX®system to correct severe reflux after sleeve gastrectomy is a safe alternative procedure to conversion to a RYGB.
authors.affiliation: Department of Minimally Invasive Surgery, St. John Hospital & Medical Center, Detroit, MI, United States. Electronic address: Eastsidesurgical@aol.com.
authors.forename: Abdelkader
authors.initials: A
authors.lastname: Hawasli
authors.affiliation: Department of Minimally Invasive Surgery, St. John Hospital & Medical Center, Detroit, MI, United States.
authors.forename: Mark
authors.initials: M
authors.lastname: Tarakji
authors.affiliation: Department of Minimally Invasive Surgery, St. John Hospital & Medical Center, Detroit, MI, United States.
authors.forename: Moayad
authors.initials: M
authors.lastname: Tarboush
keywords: Case report; GERD; LINX(®); Reflux; Roux-en-Y gastric bypass; Sleeve gastrectomy