Our Summary

This research paper discusses a rare medical condition called gastric remnant volvulus that can occur after a specific type of weight loss surgery known as Roux-en-Y gastric bypass (RYGB). The condition involves a twisting of the stomach that can lead to serious complications.

This case study focuses on a 32-year-old woman who developed this stomach twisting after her gastric sleeve surgery was converted to an RYGB procedure. Because there are so few cases of this, there’s not a lot of information about the best way to treat it. In previous instances, doctors have either attached the stomach to the abdominal wall (gastropexy) or removed the part of the stomach that’s causing trouble.

In this particular case, the woman’s anatomy meant that attaching the stomach wasn’t possible, so the doctors had to remove the problematic part of her stomach. The authors of the paper suggest that surgery is likely the best treatment for other patients in the same situation, but they also emphasise the need for more research. This is especially important because the type of surgery that led to this woman’s complications is becoming more common.

FAQs

  1. What is gastric remnant volvulus?
  2. What are the current management options for gastric remnant volvulus following RYGB surgery?
  3. Why is further study needed on the management of post-RYGB gastric remnant volvulus?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastric sleeve surgery is to carefully follow post-operative instructions and attend all follow-up appointments. This can help monitor for any potential complications, such as gastric remnant volvulus, and ensure proper healing and successful weight loss outcomes. It is important to communicate any concerning symptoms or changes in health to your healthcare provider promptly.

Suitable For

Patients who are typically recommended for a gastric sleeve procedure are those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea. Gastric sleeve surgery is also recommended for patients who have not been successful with other weight loss methods such as diet and exercise.

In the case of gastric remnant volvulus following gastric sleeve conversion to Roux-en-Y gastric bypass (RYGB), as presented in the case study, surgical intervention may be necessary. Patients who undergo gastric sleeve conversion to RYGB are at risk for complications such as gastric remnant volvulus, and it is important for healthcare providers to be aware of this potential complication.

Overall, patients who are recommended for gastric sleeve surgery should be carefully evaluated by a multidisciplinary team of healthcare professionals to determine if they are suitable candidates for the procedure. It is important for patients to be informed of the potential risks and complications associated with gastric sleeve surgery, as well as the post-operative care and follow-up required for successful weight loss and overall health improvement.

Timeline

Before gastric sleeve surgery:

  1. Patient undergoes pre-operative assessments and consultations with healthcare providers.
  2. Patient may be required to follow a pre-surgery diet and lifestyle changes to prepare for the procedure.
  3. Surgery is performed to remove a portion of the stomach and create a smaller sleeve-shaped stomach.

After gastric sleeve surgery:

  1. Patient is closely monitored in the hospital for complications and recovery.
  2. Patient is advised to follow a specific post-operative diet and exercise regimen to promote weight loss.
  3. Patient experiences gradual weight loss and improvement in obesity-related health conditions.
  4. Patient attends follow-up appointments with healthcare providers to monitor progress and address any concerns.
  5. Patient may undergo additional procedures or interventions if complications arise, such as gastric remnant volvulus following conversion to RYGB.
  6. Surgical intervention is likely indicated for gastric remnant volvulus that develops following RYGB to improve patient outcomes and establish comprehensive guidelines for this uncommon condition.

What to Ask Your Doctor

  1. What are the potential risks and complications of gastric sleeve surgery?
  2. How will my diet and eating habits need to change after gastric sleeve surgery?
  3. What kind of follow-up care will I need after the surgery?
  4. How long is the recovery period after gastric sleeve surgery?
  5. What are the signs and symptoms of gastric remnant volvulus, and how can I recognize them?
  6. What is the treatment for gastric remnant volvulus, and what are the success rates?
  7. Are there any specific warning signs or symptoms that I should watch for after gastric sleeve surgery that may indicate a potential complication like gastric remnant volvulus?
  8. How common is gastric remnant volvulus after gastric sleeve surgery?
  9. Are there any lifestyle changes or precautions I should take to reduce my risk of developing gastric remnant volvulus?
  10. Are there any long-term effects or complications associated with gastric sleeve surgery that I should be aware of?

Reference

Authors: Roberts CE, Mansour MR, Nageeb EM, Krause KR. Journal: J Minim Invasive Surg. 2024 Dec 15;27(4):217-220. doi: 10.7602/jmis.2024.27.4.217. PMID: 39675755