Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy
Piriform fossa and/or esophageal injuries caused by calibration tubes are relatively rare and remain unelucidated. Herein, we report the case of a 36-year-old woman with morbid obesity, sleep apnea, and menstrual abnormalities who was scheduled to undergo laparoscopic sleeve gastrectomy (LSG). We in...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/11/3824 |
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| author | Taiki Nabekura Takashi Oshiro Kotaro Wakamatsu Natsumi Kitahara Yuki Moriyama Kengo Kadoya Ayami Sato Tomoaki Kitahara Tasuku Urita Yu Sato Masaru Tsuchiya Shinich Okazumi |
| author_facet | Taiki Nabekura Takashi Oshiro Kotaro Wakamatsu Natsumi Kitahara Yuki Moriyama Kengo Kadoya Ayami Sato Tomoaki Kitahara Tasuku Urita Yu Sato Masaru Tsuchiya Shinich Okazumi |
| author_sort | Taiki Nabekura |
| collection | DOAJ |
| description | Piriform fossa and/or esophageal injuries caused by calibration tubes are relatively rare and remain unelucidated. Herein, we report the case of a 36-year-old woman with morbid obesity, sleep apnea, and menstrual abnormalities who was scheduled to undergo laparoscopic sleeve gastrectomy (LSG). We inserted a 36-Fr Nelaton catheter made of natural rubber as a calibration tube during the surgery. However, excessive resistance was observed. We confirmed a submucosal layer detachment approximately 5 cm from the left piriform fossa to the esophagus using intraoperative endoscopy. Additionally, LSG was performed using an endoscope as the guiding calibration tube. We inserted a nasogastric tube under endoscopy with a guidewire before completing the surgery, hoping for a guiding effect on the saliva flow. After 17 months, the patient had successfully lost weight postoperatively without complaints of neck pain or discomfort during swallowing. Therefore, in cases where the damage is limited to the submucosal layer, as in this case, conservative therapy should be considered; this is similar to the concept of endoscopic submucosal dissection not requiring suture closure. This case highlights the risk of iatrogenic injuries to the piriform fossa and/or esophagus during LSG and the importance of careful calibration tube insertion to prevent them. |
| first_indexed | 2024-03-11T03:03:31Z |
| format | Article |
| id | doaj.art-4db4251542dc484f8e5fe6e31d9334d0 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T03:03:31Z |
| publishDate | 2023-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4db4251542dc484f8e5fe6e31d9334d02023-11-18T08:06:56ZengMDPI AGJournal of Clinical Medicine2077-03832023-06-011211382410.3390/jcm12113824Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve GastrectomyTaiki Nabekura0Takashi Oshiro1Kotaro Wakamatsu2Natsumi Kitahara3Yuki Moriyama4Kengo Kadoya5Ayami Sato6Tomoaki Kitahara7Tasuku Urita8Yu Sato9Masaru Tsuchiya10Shinich Okazumi11Department of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanDepartment of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, JapanPiriform fossa and/or esophageal injuries caused by calibration tubes are relatively rare and remain unelucidated. Herein, we report the case of a 36-year-old woman with morbid obesity, sleep apnea, and menstrual abnormalities who was scheduled to undergo laparoscopic sleeve gastrectomy (LSG). We inserted a 36-Fr Nelaton catheter made of natural rubber as a calibration tube during the surgery. However, excessive resistance was observed. We confirmed a submucosal layer detachment approximately 5 cm from the left piriform fossa to the esophagus using intraoperative endoscopy. Additionally, LSG was performed using an endoscope as the guiding calibration tube. We inserted a nasogastric tube under endoscopy with a guidewire before completing the surgery, hoping for a guiding effect on the saliva flow. After 17 months, the patient had successfully lost weight postoperatively without complaints of neck pain or discomfort during swallowing. Therefore, in cases where the damage is limited to the submucosal layer, as in this case, conservative therapy should be considered; this is similar to the concept of endoscopic submucosal dissection not requiring suture closure. This case highlights the risk of iatrogenic injuries to the piriform fossa and/or esophagus during LSG and the importance of careful calibration tube insertion to prevent them.https://www.mdpi.com/2077-0383/12/11/3824laparoscopic sleeve gastrectomybariatric and metabolic surgerycomplicationiatrogenic piriform fossa and esophageal injuryorogastric calibration tube |
| spellingShingle | Taiki Nabekura Takashi Oshiro Kotaro Wakamatsu Natsumi Kitahara Yuki Moriyama Kengo Kadoya Ayami Sato Tomoaki Kitahara Tasuku Urita Yu Sato Masaru Tsuchiya Shinich Okazumi Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy Journal of Clinical Medicine laparoscopic sleeve gastrectomy bariatric and metabolic surgery complication iatrogenic piriform fossa and esophageal injury orogastric calibration tube |
| title | Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy |
| title_full | Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy |
| title_fullStr | Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy |
| title_full_unstemmed | Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy |
| title_short | Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy |
| title_sort | piriform fossa injury during calibration tube insertion in laparoscopic sleeve gastrectomy |
| topic | laparoscopic sleeve gastrectomy bariatric and metabolic surgery complication iatrogenic piriform fossa and esophageal injury orogastric calibration tube |
| url | https://www.mdpi.com/2077-0383/12/11/3824 |
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