Stomach Twisted After Gastric Sleeve

Gastric sleeve surgery is the most performed weight loss surgery in the United States today. In 2021 alone, over 150,000 of these popular surgical procedures were completed. This bariatric surgery is most often done using a laparoscope through smaller incisions that are made on the abdomen and is considered significantly less invasive than an open procedure and less complicated than a gastric bypass.

Today we are going to talk about one of the rare but possible complications that can occur after undergoing this surgery.

What Exactly Is A Twisted Stomach After Gastric Sleeve?

A twisted stomach happens when the stomach abnormally rotates or twists around onto itself, leading to a partial or complete obstruction of the blood supply and food that is traveling along the digestive pathway. This condition can have serious consequences if not dealt with quickly, so it is important to be able to identify the warning signs.

How Can Patients Recognize A Stomach Twist After Gastric Sleeve?

Some patients whose stomach has twisted after gastric sleeve experience ongoing acid reflux and intolerance to certain foods. However, these symptoms can be quite normal after this type of surgery, so they may not even realize they have a twist.

If signs of this complication manifest, then a contrast imaging test should be conducted to confirm and identify the type of stricture present.

These telltale signs of a gastric twist include:

  • Severe pain in the abdomen;
  • Ongoing nausea;
  • Unrelenting vomiting;
  • Bloating caused by the inability to pass gas;
  • Severe constipation;

How Does A Stomach Twist After Gastric Sleeve Happen?

The stomach’s normal position is between the spleen, liver, and diaphragm and is anchored by ligaments that run between itself and all these areas. If these ligaments become lax or elongated, it may give the stomach an opportunity to flip over itself and do a 180-degree rotation. This can occur naturally due to a deformity, adhesions remaining from a previous surgery, tumors, or hiatal hernias. The most frequently reported reason for this complication is that the staples put in during the gastric sleeve surgery are not aligned as they should be. It is critical that you choose a surgeon who is an expert in performing this surgery and has a proven track record.

When this happens to an un-altered stomach, the medical term used to describe it is gastric volvulus, but when gastric volvulus happens post-sleeve, the term used to describe it most accurately is gastric torsion. The difference is that gastric volvulus occurs when the stomach is whole and the ligaments are anchored to it, and gastric torsion occurs when the stomach twists upon itself after the stomach’s natural points of fixation have been altered by gastric sleeve surgery.

Another term you may hear used to describe this complication is gastric remnant twist. The portion of the stomach that remains after a bariatric procedure is called the “remnant”, which is the same term that is used to describe the piece of leftover fabric after most of the bolt has been used.

How Frequently Does A Twisted Stomach Occur After Gastric Sleeve?

Every surgery has associated risks, and a twisted stomach after gastric sleeve occurs in approximately 0.2% to 4% of all cases. This complication can occur anywhere between a few days and a year after surgery.

For a point of reference, if 4% of the individuals who underwent this weight loss surgery in 2021 experienced this rare complication, then that translates to 6,000 people having their stomachs twisted after gastric sleeve surgery. It is important to understand the signs and symptoms of this complication so quick action and intervention can be taken.

What Can Happen If A Stomach Twist Is Left Untreated?

Sometimes a twist may be present and the individual is asymptomatic, with the exception of symptoms of GERD. In these cases, the stomach twist is not creating a blockage and patients can go undiagnosed.

An untreated twist may worsen and cause sudden and severe abdominal pain, chronic nausea and persistent unproductive vomiting, severe acid reflux, and death.

If you have had gastric sleeve surgery and suspect a stomach twist, you should contact your doctor for an imaging test to have it checked out.

How Is A Twisted Stomach After Gastric Sleeve Corrected?

Treatment for patients who experience this complication can range from just observational management to another surgical procedure. Sometimes a balloon dilation is done, or they endoscopically insert a stent into the twisted area to hold it in place. One medical paper stated that the best way to treat a twisted stomach after gastric sleeve was to prevent it from occurring in the first place by using proper techniques during surgery.

In many cases, a twist after gastric sleeve can only be corrected by converting the patient’s procedure to a gastric bypass. One woman recounted her experience with this complication on a website called bariatricpal.com and said the obstruction caused by her twist gave her such awful reflux, and she was in terrible pain despite being on high doses of prescription medication designed to treat GERD. She reported that a revision to gastric bypass surgery solved everything.

How Can You Get The Weight Loss Potential Of Gastric Sleeve And Avoid A Stomach Twist?

Although gastric sleeve surgery has a history of success, because it is a surgical procedure, it poses elevated risks. There is a procedure that offers the same benefits as this surgery and more. Suture Sculpt ESG is a non-surgical weight loss procedure that creates a smaller stomach without any incisions or invasive changes. This FDA-approved procedure is totally performed using endoscopy and offers significantly reduced risk factors over surgery and a super-speedy recovery.

No portion of the stomach is removed, and therefore the ligaments that pin the stomach to its surrounding neighboring organs are left undisturbed, so experiencing a twist would be extremely rare and not due to surgical technique. Additionally, many individuals experience acid reflux forever after undergoing gastric sleeve surgery, but Suture Sculpt ESG uses a different technique, and reflux is rarely an issue for ESG patients.

If you would like to learn more about how to lose weight safely with Suture Sculpt, contact Batash Endoscopic Weight Loss Center. We would love to speak with you about your options for effective weight management that are much safer than surgery. Dr. Steven Batash is an expert in obesity management, and his track record speaks for itself. He and his team at Batash Endoscopic Weight Loss Centers are ready to partner with you to craft the best individualized plan that will help you attain better health and reach your weight loss goals.

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