Back to 2025 Posters
SAFETY & EFFECTIVENESS OF LAPAROSCOPIC LIGAMENTUM TERES CARDIOPEXY WITH INTRAOPERATIVE ENDOFLIP FOR INTRATHORACIC SLEEVE MIGARATION IN PATIENTS WITH SEVERE COMORBIDITIES
Timothy Trestrail, William Scola
*, Talia R. Arcieri, Jack Sleeman, Sunil Amin, Morgan Shane, Onur C. Kutlu
General Surgery , University of Miami - Jackson Memorial Hospital, Miami, FL
Background: Hiatal hernias after sleeve gastrectomy, especially intrathoracic sleeve migration, have become more common due to the increasing rate of bariatric surgery. Conversion to Roux-en-Y gastric bypass (RNYGBP) with repair of the hernia is accepted as the most effective option for management of these patients. However, for patients with comorbidities that prevent candidacy or who are unwilling, ligamentum teres cardiopexy (LTC) has been proposed as an effective alternative. This study outlines the pre-operative characteristics, surgical technique and post-operative outcomes of LTC.
Methods: Patients who underwent LTC from 2021-2023 at a tertiary referral academic institution were retrospectively reviewed.
Results: 18 patients were identified who underwent LTC; 17 with sleeve migration and 1 with gastric bypass pouch migration. 94% were female, mean age was 47 (34-78) years. Criteria for non-RNYGBP management were cirrhosis (2), renal transplant recipient (2), Parkinson’s disease (2), Crohn’s disease (2), Von Willebrand’s disease (1), normal body mass index (3), active malignancy (3), and patient preference (2). Mean operative time was 85 (54-115) minutes. Median length of stay (LOS) was 1 day (IQR = 1-2 days). 16 (88%) remained off proton pump inhibitors at 1 year. Rate of dysphagia at 4 weeks was 11% (2), and 1 (5.5%) required dilation. Readmission rate was 5% (1), there were no conversions, and no mortalities at 90 days.
Conclusion: Ligamentum teres cardiopexy is a viable alternative to RNYGBP in patients with a prior vertical sleeve gastrectomy who are not candidates for a diversion procedure.
Back to 2025 Posters
