MODIFIED LAPAROSCOPIC SLEEVE GASTRECTOMY WITH EPIPHRENIC DIVERTICULECTOMY, HELLER MYOTOMY AND DOR FUNDOPLICATION
Edward Gray*, Jad Khoraki, Guilherme M. Campos
Virginia Commonwealth University Medical Center, Richmond, VA
We present a modification to a Laparoscopic Sleeve Gastrectomy (LSG) for the combined treatment of Class II obesity and an epiphrenic esophageal diverticulum in a patient with a relative contra-indication to a gastric bypass. The patient had a BMI of 39, ESRD on hemodialysis awaiting a Renal Transplant. A large epiphrenic diverticulum was found on endoscopy, and UGI Swallow confirmed a right posterolateral diverticulum, with preserved esophageal peristalsis. Technical highlights include hiatal and diverticulum dissection and diverticulectomy, Heller myotomy, Dor Fundoplication and hiatus closure. Lastly, the modified LSG preserving the part of the fundus used for the fundoplication.
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