A study was conducted to show the preliminary results of Toupet-sleeve technique in morbid obese patients having symptomatic gastroesophageal reflux disease (GERD) and to compare the outcomes with those of patients undergoing laparoscopic sleeve gastrectomy (LSG).

Overall, 103 patients who underwent primary LSG from March 2018 through October 2020 and 18 patients who underwent partial T-sleeve were included in the study and were divided into 2 groups based on the surgical technique (Group A - primary LSG; Group B - partial T-sleeve). All patients had preoperative symptomatic GERD. Patients were evaluated for GERD symptoms and weight loss after the surgery.

The mean age of the patients included in the study was 39.2±10.2 years, with 63% female. The mean body mass index was 43.2±6.4 kg/m².

• The median operative time was 93 minutes (75 to 110 min) in group A patients and 110 minutes (90 to 120 min) in group B.
• There was a reduction in mean body mass index to 28±4.5 kg/m² in group A and 25.8±3.5 kg/m² in group B at 12 months post-surgery.
• At the 12th month, the patients were assessed for GERD symptoms. Reflux symptoms were resolved in 62% of the patients in group A. Around 32% of the patients (n=39) had persistent GERD symptoms.
• In group B, all the patients had discontinued proton pump inhibitors after the surgery, with complete resolution of GERD symptoms in 94% of these patients.

T-sleeve technique was associated with good weight loss and reflux control in morbid obese patients with symptomatic GERD over the short-term period.

Source: Türkçapar AG, Åžen O. Combined Partial Toupet Fundoplication with Laparoscopic Sleeve Gastrectomy for Patients with Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique. Surg Laparosc Endosc Percutan Tech. 2022 Mar 8.