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Background: Gastric obstructions (LSG) leaks and staple line bleeding are reported after laparoscopic sleeve gastrectomy. There is no ideal method or technique to avoid these mishaps. modified omentopexy (OP) added to LSG to determine if there is any effect on gastric leaks and other complications. The aim of this study was the assessment of safety & feasibility of the omentopexy technique in Laparoscopic sleeve gastrectomy.Objective: This study aimed to assess the safety & feasibility of the omentopexy technique in Laparoscopic sleeve gastrectomy. Patients and Methods: This prospective randomized controlled clinical trial study was conducted in the Zagazig University hospital including 32 patients with morbid obesity who were admitted to the General Surgery Department, for intervention surgery with laparoscopic sleeve gastrectomy during the period from July 2020 to July 2021. Patients underwent a standardized preoperative assessment, including a complete history, physical examination, and psychological evaluation. Results: There was a highly statistically significant decrease in mean weight and BMI at six months postoperative compared to pre-operative Laparoscopic sleeve gastrectomy with and without omental fixation group. Conclusion: Omentopexy may not change the outcome for a laparoscopic sleeve gastrectomy in terms of gastrointestinal symptoms or weight loss results although it is associated with longer operative time. However, it may serve as an extra guard against leakage, bleeding, vomiting, and gastroesophageal reflux disease, manifested by the decreased incidence of these complications with that technique. Laparoscopic sleeve gastrectomy with omentopexy can be a feasible procedure for decreasing morbidity and gastric leak rate.

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Background: Despite laparoscopic sleeve gastrectomy's (LSG) success as a surgical treatment for morbid obesity, complications are not uncommon and can have serious consequences, including patient death. Objective: To report late complications of LSG that may be encountered after one month, including stricture, nutritional complications, and gastroesophageal reflux disease (GERD).

Objective: Esophageal perforation (EP) is a fatal status that continues to be challenging the management, with the incidence of mortality and morbidity has been reported to reach 40%. Its diagnosis may be tricky as it usually presents with a wide range of non-specific symptoms. Our study aims to report characteristics, relay our experience with EP management, and evaluate the various strategies used. Methods: This study retrospectively evaluated the management of 53 patients with EP over 13 years. The confirmed diagnosis was established by esophagogram with water-soluble contrast, contrast-enhanced computed tomography, and esophagus-gastro-duodenoscopy. Initial management was categorized as conservation, endoscopic stent, or surgery. Re-intervention and different outcomes were recorded and analyzed. Results: Thoracic EP is the most common location (71.7%). The most common cause of EP was iatrogenic (35.8%). About 58.5% of patients were diagnosed ≤ 24 hours. The mean Pittsburg severity score was 7.5. The initial management was conservation (35.8%), an endoscopic stent (17%), and surgical intervention (47.2%). ICU and organ support were needed in 35.8% and 20.8%, respectively. The mean hospital stay for all patients was 27.7 days. Morbidity and mortality were recorded at 30.2% and 18.9%, respectively. Conclusion: EP management should be flexible with a tailored strategy for every patient. Etiology, site, severity score, time to management, and patient reserve are significant factors in management and prognosis.