Abstract Introduction Nissen sleeve gastrectomy (NSG) is a bariatric procedure based on the combination of 2 well-known surgical techniques (vertical sleeve gastrectomy and Nissen fundoplication). It was presented in 2016 by Nocca et al. as a means to prevent the major drawback of sleeve gastrectomy (SG)—post-SG gastroesophageal reflux disease (GERD) and associated complications, while preserving the advantages of SG in terms of weight loss and remission of obesity-related comorbidities. Methods We present the case of a 51 years-old female patient with a body mass index of 33.4 kg/m2 and complaints of acid reflux. She had a family history of gastric cancer (father at 50 years-old). Upper gastrointestinal endoscopy exhibited grade A esophagitis, a 6 mm hyperplasic polyp in the cardia and a 1.2 cm subepithelial lesion in the duodenum. Discussion Given the patient’s background—GERD symptoms and the need to maintain endoscopic surveillance of the stomach and duodenum, she underwent a Nissen Sleeve procedure. The patient made a full recovery and was discharged on postoperative day 2, with a liquid foods diet. During follow-up, the patient had no reported symptoms of GERD and exhibited good weight loss results (EWL 83.9%). Conclusion According to current literature, the Nissen sleeve gastrectomy achieves a satisfactory long-term weight loss and a significant improvement in comorbidities, particularly regarding the incidence of GERD. The rate of complications requiring surgical reoperation is relatively low. However, evidence is still not enough to consider NSG a new gold-standard for morbid obesity. It is a safe and feasible option, in cases such as the one presented. The approach to morbid obesity and GERD should be tailored to each patient and its unique characteristics. It is, in fact, a good alternative option in exceptional cases.
Coutinho et al. (Thu,) studied this question.