The New Interest of Bariatric Surgeons in the Old Ligamentum Teres Hepatis

Obes Surg. 2020 Nov;30(11):4592-4598. doi: 10.1007/s11695-020-04918-1. Epub 2020 Aug 17.

Abstract

The search for an operation that effectively prevents and treats intrathoracic gastric migration (ITGM) after bariatric surgery has revived a long-forgotten technique: ligamentum teres cardiopexy (LTC) by which a vascularized flap of the teres ligament is wrapped around the distal esophagus. The systematic search of publications in the English language revealed 4 studies (total number of patients 53) in the non-bariatric literature with an unsatisfactory resolution of GERD. There were 5 reports from the bariatric literature with small patient numbers (total 64) and a short follow-up (6-36 months). There were no objective signs of gastric remigration in 93% of investigated patients. Acknowledging the limitations of these preliminary reports, bariatric surgeons are encouraged to further investigate the potentials of LTC in their patients.

Keywords: Bariatric surgery; GERD; Hiatal hernia; Intrathoracic gastric migration; Ligamentum teres hepatis; Round ligament; Sleeve gastrectomy.

Publication types

  • Review

MeSH terms

  • Gastroesophageal Reflux*
  • Humans
  • Obesity, Morbid* / surgery
  • Round Ligament of Liver*
  • Round Ligaments*
  • Surgeons*