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Background

Sleeve gastrectomy is the most common procedure performed, but due to the potential for GERD and its long term consequences it cannot be universally applied. Our hypothesis is that increasing the angle at the incisura angularis using omentopexy would improve long term acid reflux by preventing partial obstruction at the incisura and reducing upper stomach pressure.

Methods

Data obtained retrospectively from 01/2014-12/2015. Using 5 year follow up data, groups were divided depending if they had omentopexy or not during their surgery and if they use medication or not for GERD symptoms prior to surgery and at follow up.

Results

128 patients identified. 87 of those patients had omentopexy performed during their surgery and 41 did not. Chi square from all patients resulted in a 0.03 p-value. Out of the patients that did not use any medication treatment prior to surgery, 32% of patients without omentopexy worsened compared to 18% in the omentopexy group (p-value 0.09). In patients that use medication prior to surgery, in the group with omentopexy, 36% improved and only 12% worsened.

Conclusions

88% of the patients, which were in treatment prior to surgery, remained in the same treatment or improved after surgery when the angle at the incisura was increased using omentopexy. Also, only 18% were started on some form of antacid after 5 year follow up in the omentopexy group which trended towards significance when compared to the non omentopexy group. Omentopexy has minimal complications and can offer improve GERD control at 5 years.