Cascade Stomach as a Risk Factor for Incomplete Resection of the Gastric Fundus in Laparoscopic Sleeve Gastrectomy: a Point of Technique

In 1941, Schaffner et al. reported a case of a patient suffering from cascade stomach (CS) who underwent surgical exploration, using these words: “the fundus of the stomach was very much larger than usual, somewhat thickened, but atonic and flaccid. The space above the pancreas and behind the fundus was deeper and larger than usual. The fundus was freed. Its superior attachments appeared elongated and lax. The entire fundus was resected laterally to below the level of the splenic artery, leaving only a strip on the lesser curvature side about one and one-half inches wide. This was converted into a tube not much larger than the esophagus itself”. This is very likely the first description of a sleeve gastrectomy (SG) ante litteram