Laparoscopic Sleeve Gastrectomy with Hiatal Hernia Repair

Technique description:

1. Stapling using a new articulated stapler with slow tissue compression

2. Steps to minimize post-operative bleeding

3. Hiatal hernia repair 

Case Record:

• 30 y.o female, with a BMI of 42.9 kg/m2

• Mild GERD on intermittent Pantoprazole, Hypertriglyceridemia, Joint pains, and Depression-Anxiety.

• Preoperative Gastroscopy did not reveal any esophagitis, Barrett’s, or gastritis.

Procedure steps:

1. Mobilization of the gastric greater curvature

2. Meticulous short gastric vessels ligation near splenic hilum

3. Fundus mobilization and Stapling

4. Reinforcements and leak test

5. Hiatal hernia repair with posterior cruroplasty Specimen extraction and wounds closure

Training objectives:

• Learn to minimize bleeding for outpatient surgery

• Hiatal hernia repair may become routine