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). CONCLUSION: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.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Angrisani L,Iovino P,Lorenzo M,Santoro T,Sabbatini F,Claar E,Nicodemi O,Persico G,Tesauro B

doi

10.1381/096089299765553007

subject

Has Abstract

pub_date

1999-08-01 00:00:00

pages

396-8

issue

4

eissn

0960-8923

issn

1708-0428

journal_volume

9

pub_type

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