The goal of this clinical trial is to test gastropexy as a measure to reduce reflux in morbidly obese patients being submitted to sleeve gastrectomy. The main questions it aims to answer are: Does gastropexy reduce reflux symptoms? Does gastropexy reduce objective evidence of reflux? Participants will be randomized to gastropexy or no gastropexy, and researchers will compare these groups to see if reflux (symptoms / objective evidence of) is different in the two groups.
Laparoscopic sleeve gastrectomy (LSG) has become the most commonly performed bariatric procedure worldwide. LSG consists of a longitudinal resection of the stomach leaving the intestines intact, thereby lowering the risk for side-effects due to rerouting of the small bowel. However, gastro-esopageal reflux disease (GERD) has been reported to increase after LSG. Our hypothesis is that GERD is mainly due to intrathoracic migration of the gastric remnant. The aim of this study is to explore if suturing the gastric remnant to the gastrocolic ligament (gastropexy) will prevent intrathoracic migration and thereby reduce the development of reflux. Patients planned for a sleeve gastrectomy will be invited to participate, and participating patients will be randomized to pexi or no pexi. According to power calculations a total of 550 patients will be randomized in the study. Follow-up will be at six weeks, one-, two- and five years.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
550
Gastropexy in this project means suturing the gastric remnant to the gastrocolic ligament.
Sleeve gastrectomy without suturing the gastric remnant to the gastrocolic ligament.
Helse Forde
Førde, Norway
NOT_YET_RECRUITINGAleris Oslo
Oslo, Norway
RECRUITINGVolda sjukehus
Volda, Norway
RECRUITINGVoss sjukehus
Number of participants using acid-reducing medication (ARM) or having had reoperations due to GERD
ARM: Daily use of ARM for the last month
Time frame: Two years
Endoscopic findings
Visible oesophagitis according to the LA classification
Time frame: Two years
Patient related outcome
GerdQ questionnaire
Time frame: Two years
pH-metry
pH measurement by Bravo capsule
Time frame: Two years
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Voss, Norway