Reinforcement of the Esophageal Hiatus Using Ligamentum Teres During Sleeve Gastrectomy: Outcomes Regarding Gastroesophageal Reflux Disease and Hiatal Hernia

Background: Laparoscopic sleeve gastrectomy (LSG) is a surgery that involves the removal of 75–80% of the stomach. It offers benefits like less postoperative pain and better recovery compared to open surgery, but it also carries the risk of developing gastroesophageal reflux disease (GERD) and hiatus hernia. Patients and Methods: This retrospective study included a group of patients who underwent LSG, divided into two groups: Group A, which contained 30 patients who received LSG without ligamentum teres reinforcement (LTR), and Group B, with 30 patients, who underwent LSG with the additional LTR procedure. Results: Group B experienced significantly fewer reflux symptoms during follow-up at 3, 9, and 18 months ( p < 0.05). Additionally, Group B had a lower incidence of endoscopic reflux at 6 and 18 months (3.3% vs. 26.7% and 6.7% vs. 30.0%). Hiatus hernia size was significantly smaller in Group B (1.2 cm vs. 2.5 cm, p < 0.001). Conclusion: Incorporating LTR during LSG may reduce postoperative GERD. The small sample size and retrospective design suggest the need for larger studies to confirm LTR’s long-term benefits as an adjunctive technique in bariatric surgery.