Hiatal hernia after sleeve gastrectomy

Discussion:

Sleeve gastrectomy (SG) is a frequent surgical procedure for the treatment of morbid obesity. De novo hiatal hernia of the gastric tube can occur as a complication.

The suggested mechanisms responsible for the development of a hiatal hernia after sleeve gastrectomy are:

  1. dissection of hiatal ligaments (phrenogastric and phreno-oesophagal ligaments during the creation of the gastric tube)
  2. tubular shape of the gastric sleeve and the difficulty in anchoring the sleeve to the surrounding structures
  3. rapid weight loss following the SG may lead to enlargement of the hiatal orifice
  4. regaining of body weight and the dilatation of the whole gastric tube might also be a factor because of the increase in intragastric pressure

 

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