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Eskander et al. Mini-invasive Surg 2024;8:32 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.71

Original Article Open Access

Robotic or laparoscopic SLEEVE-DOR (sleeve

gastrectomy with anterior Dor 180° fundoplication)
for obesity: preliminary results of a series of 80

patients

1
1
1
2
Wael Eskander , Renjie Li , Maximilian Specht , André Teixeira , Ricardo Zorron 1
1
Center for Bariatric and Metabolic Surgery, Klinikum Ernst von Bergmann, Potsdam 14467, Germany.
2
Orlando Health Weight Loss and Bariatric Institute, Orlando, FL 32806, USA.
Correspondence to: Dr. Ricardo Zorron, Center for Bariatric and Metabolic Surgery, Klinikum Ernst von Bergmann,
Charlottenstraße 72, Potsdam 14467, Germany. E-mail: rzorron@gmail.com
How to cite this article: Eskander W, Li R, Specht M, Teixeira A, Zorron R. Robotic or laparoscopic SLEEVE-DOR (sleeve
gastrectomy with anterior Dor 180° fundoplication) for obesity: preliminary results of a series of 80 patients. Mini-invasive Surg
2024;8:32. https://dx.doi.org/10.20517/2574-1225.2024.71

Received: 31 Aug 2024 First Decision: 6 Nov 2024 Revised: 15 Nov 2024 Accepted: 19 Nov 2024 Published: 30 Nov 2024
Academic Editor: Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Aims: Sleeve gastrectomy (SG) is currently the most performed bariatric surgery worldwide. For patients with
obesity and symptomatic gastroesophageal reflux disease (GERD), the indication of SG is a matter of concern due
to the possibility of worsening or de novo reflux in the postoperative follow-up. A new method, the combination of
a 180-degree anterior fundoplication (SLEEVE-DOR) using only one barbed nonabsorbable suture, is proposed to
allow the use of SG for this set of patients aiming to minimize the occurrence of de novo GERD. The study aims to
evaluate the safety, feasibility and efficacy of SG with SLEEVE-DOR for the therapy of patients with obesity.

Methods: The study describes the largest series of SG combined with anterior hemifundoplication. Since June
2018, all patients with indications for bariatric surgery and having proton pump inhibitor (PPI) therapy for
symptomatic reflux at least 6 months before surgery were prospectively documented. All operations were
performed laparoscopically (45) or with a robotic DaVinci platform (35). Clinical data were collected from our
bariatric center database. The primary outcomes included technical success, perioperative complications and
mortality, and the resolution of symptomatic gastroesophageal reflux after the SLEEVE-DOR procedure.

Results: The procedure was successfully performed for all patients (n = 80). Mean operative time was 60.1 min. All
patients started oral fluids one hour after the surgery and were discharged between 1st and 3rd postoperative day.

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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