BARICLIP PLACEMENT IN A PATIENT WITH RECURRENT HIATAL HERNIA: IS IT FEASIBLE? andres.herma92@gmail.com

 

BARICLIP PLACEMENT IN A PATIENT WITH RECURRENT HIATAL HERNIA: IS IT FEASIBLE?

4

Mexico

Poster Exhibition only

Obesity is a global health problem associated with gastroesophageal reflux disease (GERD) and hiatal hernia, both of which significantly affect quality of life. Traditional bariatric procedures such as sleeve gastrectomy are effective for weight loss but frequently exacerbate GERD due to disruption of the lower esophageal sphincter and increased intragastric pressure. In contrast, laparoscopic gastroplasty with BariClip has emerged as a restrictive, reversible, and stomach-preserving option that appears to minimize reflux risk.

We present the case of a 43-year-old female with a history of hypothyroidism, smoking, and previous laparoscopic Nissen fundoplication for GERD and hiatal hernia. She developed recurrent reflux symptoms and was diagnosed with a recurrent hiatal hernia. The patient underwent laparoscopic surgery including complete dismantlement of the prior fundoplication, repair of a 6 cm hiatal defect, and BariClip placement calibrated with a 36 Fr orogastric tube. Fixation was reinforced with anterior and posterior gastric sutures to avoid clip migration.

This approach provided both hernia correction and a restrictive bariatric effect, addressing GERD symptoms and obesity simultaneously. Recent literature supports BariClip’s potential advantages over sleeve gastrectomy, including preservation of the angle of His and esophageal sphincter fibers, reduced intragastric pressure, and low complication rates. In published series, most patients experienced symptom improvement with minimal de novo GERD and no erosions.

Our case, to our knowledge the first reported in this setting, demonstrates the feasibility of combining hiatal hernia repair with BariClip placement after failed fundoplication. This strategy may be a safe, reversible alternative in selected patients, warranting further evaluation.