The potential of a polyglycolic acid sheet for preventing intrathoracic sleeve migration

Minim Invasive Ther Allied Technol. 2023 Aug;32(4):199-206. doi: 10.1080/13645706.2023.2224437. Epub 2023 Jun 19.

Abstract

Introduction: Postoperative gastroesophageal reflux disease (GERD) can be a consequence of laparoscopic sleeve gastrectomy (LSG). Intrathoracic sleeve migration (ITSM) is a factor contributing to its development. This study aimed to investigate whether the occurrence of ITSM can be prevented by applying a polyglycolic acid (PGA) sheet around the His angle.

Material and methods: In this retrospective analysis, 46 consecutive patients who underwent LSG were divided into two groups: Group A - our standard LSG in the first half (n = 23) and Group B - our standard LSG with PGA sheet covering the angle of His in the second half (n = 23). We compared the two groups for one-year postoperative GERD and the incidence of ITSM.

Results: No significant differences were found between the two groups in terms of patient background, operation time, and one-year postoperative total body weight loss, and no adverse effects related to the PGA sheet were observed. Group B had a significantly lower incidence of ITSM than Group A, and the rate of acid-reducing medicine usage was less pronounced in Group B during follow-up (p < .05).

Conclusion: This study suggests that applying a PGA sheet can be safe and effective in reducing postoperative ITSM and preventing exacerbations of postoperative GERD.

Keywords: Laparoscopic sleeve gastrectomy (LSG); gastroesophageal reflux disease (GERD); intrathoracic sleeve migration (ITSM); polyglycolic acid (PGA) sheet; prevention.

MeSH terms

  • Gastrectomy / adverse effects
  • Gastroesophageal Reflux* / prevention & control
  • Humans
  • Laparoscopy* / adverse effects
  • Obesity, Morbid* / complications
  • Polyglycolic Acid
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Polyglycolic Acid