Up to 60% of bariatric patients present with gastroesophageal reflux disease (GERD) and approximately 20% will develop de novo GERD after bariatric surgery, particularly after a sleeve gastrectomy. Esofago-gastric reflux after a sleeve gastrectomy is caused by several factors: injury to the lower esophageal sphincter, obstructive sleeve (long and narrow tube with high intraluminal pressure), dilatation of the upper part of the sleeve, and hiatal hernia with intra-thoracic migration of the gastric tube.
Several treatment regimes have been proposed for treatment of reflux after sleeve, from medical therapy to surgical revision. In this IFSO Online Symposium, Camilo Boza and Chih-Kun Huang present the cases and treatments of patients with reflux after sleeve gastrectomy. An interesting discussion on the most appropriate treatment by a panel of IFSO experts follows.