Behind The Knife: The Surgery Podcast Journal Review in Bariatric Surgery: Worsening or De Novo GERD following Vertical Sleeve Gastrectomy
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May 19, 2022 In this insightful discussion, the hosts explore the puzzling relationship between bariatric surgery and gastroesophageal reflux disease (GERD). They question whether weight loss alone can alleviate GERD symptoms and delve into the impact of vertical sleeve gastrectomy on these conditions. The nuances of hiatal hernia repairs and their effect on postoperative GERD are highlighted, as well as contradictions in existing research. The importance of ongoing monitoring and tailored care for patients is emphasized, revealing the complexities of surgical outcomes.
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Roux-en-Y for GERD
- If patients have symptomatic GERD or breakthrough symptoms despite PPIs, consider a Roux-en-Y gastric bypass over a sleeve gastrectomy.
- This is especially important for patients with grade C or D esophagitis.
Sleeve Gastrectomy and GERD Risk
- Sleeve gastrectomy patients with significant GERD may experience breakthrough reflux.
- Preoperative evaluation with an upper GI and EGD is crucial to assess underlying esophagitis or Barrett's esophagus.
Insurance and Reoperation
- Insurance often only covers one bariatric surgery.
- This poses a challenge for sleeve gastrectomy patients who later develop GERD complications requiring reoperation.