Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy

Introduction. The Angelchik prosthesis (AP) is a historic antireflux device which consists of a C-shaped silicone ring placed around the gastroesophageal junction (GEJ) and secured by Dacron tape. We present a rare experience with an AP and its impact on bariatric surgical outcomes. Case. Our patien...

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Main Authors: Faryal G. Afridi, Morgan Johnson, Kelsey A. Musgrove, Salim Abunnaja, Lawrence E. Tabone, David C. Borgstrom, Nova Szoka
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2019/2479267
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author Faryal G. Afridi
Morgan Johnson
Kelsey A. Musgrove
Salim Abunnaja
Lawrence E. Tabone
David C. Borgstrom
Nova Szoka
author_facet Faryal G. Afridi
Morgan Johnson
Kelsey A. Musgrove
Salim Abunnaja
Lawrence E. Tabone
David C. Borgstrom
Nova Szoka
author_sort Faryal G. Afridi
collection DOAJ
description Introduction. The Angelchik prosthesis (AP) is a historic antireflux device which consists of a C-shaped silicone ring placed around the gastroesophageal junction (GEJ) and secured by Dacron tape. We present a rare experience with an AP and its impact on bariatric surgical outcomes. Case. Our patient is a 66-year-old woman who had an open antireflux procedure with an AP in 1987. She presented to a bariatric clinic for consideration of bariatric surgery for the treatment of morbid obesity and associated comorbidities. She also reported significant problems with reflux and dysphagia. After an appropriate work-up, an AP was identified at her GEJ. She was taken to the operating room for laparoscopic removal with planned interval laparoscopic sleeve gastrectomy. Intraoperatively, the AP was identified around the GEJ; after extensive adhesiolysis, the prosthesis was removed. Postoperatively, in order to determine if the AP had caused any lasting esophageal motility problems, the patient underwent a high-resolution esophageal manometry which demonstrated normal esophageal motility. Interval laparoscopic sleeve gastrectomy was performed safely 9 weeks later. Conclusion. Although rarely used, it is still possible to encounter an Angelchik prosthesis in practice. General and bariatric surgeons need to be aware of this rare device and understand how to manage its related complications.
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spelling doaj-art-982e837d56ad4f2892b171cf45e794e62025-02-03T01:03:28ZengWileyCase Reports in Surgery2090-69002090-69192019-01-01201910.1155/2019/24792672479267Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve GastrectomyFaryal G. Afridi0Morgan Johnson1Kelsey A. Musgrove2Salim Abunnaja3Lawrence E. Tabone4David C. Borgstrom5Nova Szoka6Department of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USADepartment of Surgery, West Virginia University, Morgantown, USAIntroduction. The Angelchik prosthesis (AP) is a historic antireflux device which consists of a C-shaped silicone ring placed around the gastroesophageal junction (GEJ) and secured by Dacron tape. We present a rare experience with an AP and its impact on bariatric surgical outcomes. Case. Our patient is a 66-year-old woman who had an open antireflux procedure with an AP in 1987. She presented to a bariatric clinic for consideration of bariatric surgery for the treatment of morbid obesity and associated comorbidities. She also reported significant problems with reflux and dysphagia. After an appropriate work-up, an AP was identified at her GEJ. She was taken to the operating room for laparoscopic removal with planned interval laparoscopic sleeve gastrectomy. Intraoperatively, the AP was identified around the GEJ; after extensive adhesiolysis, the prosthesis was removed. Postoperatively, in order to determine if the AP had caused any lasting esophageal motility problems, the patient underwent a high-resolution esophageal manometry which demonstrated normal esophageal motility. Interval laparoscopic sleeve gastrectomy was performed safely 9 weeks later. Conclusion. Although rarely used, it is still possible to encounter an Angelchik prosthesis in practice. General and bariatric surgeons need to be aware of this rare device and understand how to manage its related complications.http://dx.doi.org/10.1155/2019/2479267
spellingShingle Faryal G. Afridi
Morgan Johnson
Kelsey A. Musgrove
Salim Abunnaja
Lawrence E. Tabone
David C. Borgstrom
Nova Szoka
Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
Case Reports in Surgery
title Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
title_full Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
title_fullStr Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
title_full_unstemmed Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
title_short Laparoscopic Removal of Angelchik Prosthesis Followed by Interval Sleeve Gastrectomy
title_sort laparoscopic removal of angelchik prosthesis followed by interval sleeve gastrectomy
url http://dx.doi.org/10.1155/2019/2479267
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