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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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Autores principales: Nabekura, Taiki, Oshiro, Takashi, Wakamatsu, Kotaro, Kitahara, Natsumi, Moriyama, Yuki, Kadoya, Kengo, Sato, Ayami, Kitahara, Tomoaki, Urita, Tasuku, Sato, Yu, Tsuchiya, Masaru, Okazumi, Shinich
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10254006/
https://www.ncbi.nlm.nih.gov/pubmed/37298019
http://dx.doi.org/10.3390/jcm12113824
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author Nabekura, Taiki
Oshiro, Takashi
Wakamatsu, Kotaro
Kitahara, Natsumi
Moriyama, Yuki
Kadoya, Kengo
Sato, Ayami
Kitahara, Tomoaki
Urita, Tasuku
Sato, Yu
Tsuchiya, Masaru
Okazumi, Shinich
author_facet Nabekura, Taiki
Oshiro, Takashi
Wakamatsu, Kotaro
Kitahara, Natsumi
Moriyama, Yuki
Kadoya, Kengo
Sato, Ayami
Kitahara, Tomoaki
Urita, Tasuku
Sato, Yu
Tsuchiya, Masaru
Okazumi, Shinich
author_sort Nabekura, Taiki
collection PubMed
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.
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spelling pubmed-102540062023-06-10 Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy Nabekura, Taiki Oshiro, Takashi Wakamatsu, Kotaro Kitahara, Natsumi Moriyama, Yuki Kadoya, Kengo Sato, Ayami Kitahara, Tomoaki Urita, Tasuku Sato, Yu Tsuchiya, Masaru Okazumi, Shinich J Clin Med Case Report 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. MDPI 2023-06-02 /pmc/articles/PMC10254006/ /pubmed/37298019 http://dx.doi.org/10.3390/jcm12113824 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Nabekura, Taiki
Oshiro, Takashi
Wakamatsu, Kotaro
Kitahara, Natsumi
Moriyama, Yuki
Kadoya, Kengo
Sato, Ayami
Kitahara, Tomoaki
Urita, Tasuku
Sato, Yu
Tsuchiya, Masaru
Okazumi, Shinich
Piriform Fossa Injury during Calibration Tube Insertion in Laparoscopic Sleeve Gastrectomy
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 Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10254006/
https://www.ncbi.nlm.nih.gov/pubmed/37298019
http://dx.doi.org/10.3390/jcm12113824
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