ArticleSurgical endoscopy2025
Koala Sleeve: innovative technique for enhanced GERD control without sacrificing weight loss.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSleeve gastrectomy (SG) is the most frequently performed bariatric surgery worldwide, offering effective weight loss and improvement in metabolic conditions. However, one of its major complications is the exacerbation or development of gastroesophageal reflux disease (GERD), affecting over 30% of patients. While Roux-en-Y gastric bypass (RYGB) is often the preferred alternative for patients with pre-existing GERD, it may not be suitable for all patients due to contraindications or patient preference.
objectiveThis study introduces a novel modification to SG, combining it with horizontal gastroplasty to address GERD symptoms without compromising weight loss outcomes.
methodsThe procedure involves a standard SG with complete fundus resection, followed by the creation of a horizontal valve at the gastroesophageal (GE) junction using three horizontal mattress sutures. Seven patients with preoperative GERD were selected for this technique. Post-operative outcomes were assessed, including weight loss and GERD symptom resolution.
resultsThe mean operative time was 76 min, with no procedure-related complications. Three months postoperatively, the average percentage of excess weight loss (%EWL) was 68%. Importantly, none of the patients reported GERD symptoms, indicating effective reflux control.
conclusionSleeve gastrectomy with horizontal gastroplasty appears to be a promising, simple, and safe option for patients with GERD undergoing SG. This technique may offer a viable alternative to RYGB for managing GERD in bariatric patients. Further studies are needed to validate these initial findings and assess long-term outcomes.
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