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Surg Obes Relat Dis. 2015 Mar-Apr;11(2):474-7. doi: 10.1016/j.soard.2014.06.021. Epub 2014 Jul 19.

Laparoscopic median gastrectomy for stenosis following sleeve gastrectomy.

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Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom.
Department of Upper Gastrointestinal Surgery, Salford Royal Hospital, Manchester, United Kingdom; The University of Manchester, Manchester, United Kingdom. Electronic address:



Laparoscopic sleeve gastrectomy (LSG) has become an established primary bariatric procedure. Gastric stenosis after LSG has been reported in a few studies and often occurs at the level of incisura or midbody because of a technical operative error and could be associated with a leak. This can be managed by endoscopic dilations or revision surgery. The objective of this study is to describe a novel technique to deal with sleeve stenosis and its outcome.


Two patients presented with sleeve stenosis after LSG and underwent a novel technique. The patients were followed up for 18 months.


We describe a novel technique of laparoscopic median gastrectomy in 2 patients that involved resection of the stenotic segment followed by a hand-sewn, gastrogastric, end-to-end anastomosis. Both patients had successfully recovered from stenosis related symptoms, although one required an endoscopic dilation of the anastomosis.


Laparoscopic median gastrectomy is a feasible and effective option in patients who have failed conservative management of stenosis after LSG and in whom there is a desire to avoid seromyotomy or conversion to gastric bypass.


Median gastrectomy; Sleeve gastrectomy; Sleeve stenosis

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