HOME 9 Ligamentum Teres Cardiopexy Reflux Treatment

Do You Have Acid Reflux After Gastric Sleeve? Bypass is Not the Only Solution!

The experienced bariatric surgeons at Northwest Weight and Wellness Center (NWWC) offer Ligamentum Teres Cardiopexy to treat acid reflux and chronic heartburn. This procedure is a great option for patients experiencing heartburn after gastric sleeve and can be an effective alternative to gastric bypass surgery. 1

Heartburn, Acid Reflux and GERD After Gastric Sleeve Surgery

Gastric sleeve surgery, also known as laparoscopic sleeve gastrectomy, is a safe and effective bariatric surgery that has helped many patients lose weight and improve their health.2 Of course, any medical procedure carries some risk of side effects. In the case of gastric sleeve, patients may experience increased heartburn and acid reflux after surgery, with up to 35% developing gastroesophageal reflux disease (GERD).3 There are a range of treatment options available for chronic heartburn, from over-the-counter medications to surgery.

For patients whose heartburn does not respond to treatment and those who develop GERD after gastric sleeve, many bariatric surgeons recommend a sleeve-to-bypass revision surgery. At NWWC, our board-certified surgeons offer another solution: Ligamentum Teres Cardiopexy is an effective and less invasive solution to relieve GERD symptoms for sleeve patients without the need for gastric bypass4. Our surgeons have had excellent results with this procedure, which gives patients relief from chronic heartburn and reflux and allows them to reduce or stop using reflux medications.

What is Ligamentum Teres Cardiopexy and How Does it Work?

Acid reflux occurs when stomach acid splashes into the esophagus, which is the tube that connects the stomach to the mouth. When stomach acid flows upward, it irritates the esophagus and causes a painful burning sensation. There is a muscle called the lower esophageal sphincter (LES) that typically keeps stomach acid from entering the esophagus, but if the muscle is weakened, it does does not stay closed when it is supposed to—leading to heartburn, acid reflux, or GERD.

In a Ligamentum Teres Cardiopexy procedure, the LES muscle and valve are tightened. The newly strengthened LES prevents stomach acid from flowing upward to the esophagus, and this provides relief from the pain and irritation of acid reflux. Hiatal hernias are also repaired using this procedure.

Preparing for Your Procedure

The first step is to schedule a consultation appointment with one of our experienced and compassionate surgeons. We will review your medical history and discuss your concerns in order to determine your needs. If this is the best treatment option for you, we will give you detailed pre-procedure guidelines.

Recovery After Ligamentum Teres Cardiopexy

Ligamentum Teres Cardiopexy is typically an outpatient procedure performed with general anesthesia. The procedure typically takes less than an hour to complete and patients return home the same day. Patients need to follow a liquid diet for about two weeks after surgery. There may be some swelling during initial recovery, which can mimic reflux symptoms, but once swelling subsides, patients can expect relief from reflux.

Am I a Candidate for Ligamentum Teres Cardiopexy?

If you suffer from frequent heartburn or acid reflux, this procedure may be an effective option for you. Patients who have previously had gastric sleeve surgery and are seeking a solution for reflux or GERD can benefit from this procedure. Schedule a consultation appointment to determine if you are a candidate.

Contact Us

At NWWC, we are dedicated to improving quality of life for patients from Everett and Seattle Washington, as well as those who travel to see us from the greater Pacific Northwest, Idaho, Canada, and beyond. Our team takes a compassionate and comprehensive approach to patient care. Contact us with any questions or to schedule your appointment.

1 Hawasli A, Foster R, Lew D, Peck L. Laparoscopic Ligamentum Teres cardiopexy to the rescue; an old procedure with a new use in managing reflux after sleeve gastrectomy, The American Journal of Surgery, Volume 221, Issue 3, 2021.
2 Penn Medicine. Is Bariatric Surgery Safe? Available: Accessed July 15, 2022
3 Raj PP, Bhattacharya S, Misra S, Kumar SS, Khan MJ, Gunasekaran SC, Palanivelu C. Gastroesophageal reflux-related physiologic changes after sleeve gastrectomy and Roux-en-Y gastric bypass: a prospective comparative study. Surg Obes Relat Dis. 2019 Aug;15(8):1261-1269. doi: 10.1016/j.soard.2019.05.017. Epub 2019 May 20. PMID: 31279562.
4 Gálvez-Valdovinos R, Cruz-Vigo JL, Marín-Santillán E, Funes-Rodríguez JF, López-Ambriz G, Domínguez-Carrillo LG. Cardiopexy with Ligamentum Teres in Patients with Hiatal Hernia and Previous Sleeve Gastrectomy: An Alternative Treatment for Gastroesophageal Reflux Disease. Obes Surg. 2015 Aug;25(8):1539-43. doi: 10.1007/s11695-015-1740-5. PMID: 25990381.

Being in my mid-50s, change is not something I undertake casually. I had LAP-BAND® surgery with Dr. Michaelson in 2011 because I knew it was time to prioritize my health. My insurance covered the procedure, and I was able to lose 50 pounds in the first eight months. Unfortunately, by 2017, I had gained back all of the weight, plus some. I was still determined to win my lifelong battle with obesity and returned to Dr. Michaelson for a second procedure. This time I had a gastric sleeve revision, which I paid for out of pocket, so you know I believe in my surgeon! To date, I have lost 64 pounds, and I am continuing to slowly lose.

The revision was by far the best decision I have ever made for myself. I feel absolutely amazing! I traveled from Alaska for surgery on a Tuesday and flew home on Friday.
I was back at work on Monday with no issues at all. I’m loving life post-revision!

Robin M.
Wasilla, AK