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Video case report| Volume 5, ISSUE 2, P280-282, March 2009

Laparoscopic Roux-en-Y gastric bypass after previous Nissen fundoplication

Published:November 17, 2008DOI:https://doi.org/10.1016/j.soard.2008.11.004
Laparoscopic Roux-en-Y gastric bypass after previous Nissen fundoplication
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      The prevalence of both gastroesophageal reflux disease (GERD) and obesity has increased significantly during the past 25 years, and an association between the 2 has been demonstrated [
      • Fisher B.L.
      • Pennathur A.
      • Mutnick J.L.
      • et al.
      Obesity correlates with gastroesophageal reflux.
      Dig Dis Sci. 1999; 44: 2290-2294
      ,
      • Locke G.R.
      • Talley N.J.
      • Fett S.L.
      • et al.
      Risk factors associated with symptoms of gastroesophageal reflux.
      Am J Med. 1999; 106: 642-649
      ,
      • Barak N.
      • Ehrenpreis E.D.
      • Harrison J.R.
      • et al.
      Gastro-oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations.
      Obes Rev. 2002; 3: 9-15
      ,
      • El-Serag H.
      The association between obesity and GERD: a review of the epidemiological evidence.
      Dig Dis Sci. 2008; 53: 2307-2312
      ,
      • Friedenberg F.K.
      • Xanthopoulos M.
      • Foster G.D.
      • et al.
      The association between gastroesophageal reflux disease and obesity.
      Am J Gastroenterol. 2008; 103: 2111-2122
      ,
      • Ikramuddin S.
      Surgical management of gastroesophageal reflux disease in obesity.
      Dig Dis Sci. 2008; 53: 2318-2329
      ]. Laparoscopic Nissen fundoplication has been shown to be safe and effective in the treatment of GERD and to offer significant advantages compared with long-term medical therapy [
      • Lundell L.
      • Miettinen P.
      • Myrvold H.E.
      • et al.
      Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.
      J Am Coll Surg. 2001; 192: 172-181
      ,
      • Anvari M.
      • Allen C.
      Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication.
      J Am Coll Surg. 2003; 196: 51-59
      ,
      • Mahon D.
      • Rhodes M.
      • Decadt B.
      • et al.
      Randomized clinical trial of laparoscopic Nissen fundoplication compared with proton-pump inhibitors for treatment of chronic gastro-oesophageal reflux.
      Br J Surg. 2005; 92: 695-699
      ,
      • Mehta S.
      • Bennett J.
      • Mahon D.
      • et al.
      Prospective trial of laparoscopic Nissen fundoplication versus proton pump inhibitor therapy for gastroesophageal reflux disease: seven-year follow-up.
      J Gastrointest Surg. 2006; 10: 1312-1317
      ,
      • Kelly J.J.
      • Watson D.I.
      • Chin K.F.
      • et al.
      Laparoscopic Nissen fundoplication: clinical outcomes at 10 years.
      J Am Coll Surg. 2007; 205: 570-575
      ,
      • Lundell L.
      • Miettinen P.
      • Myrvold H.E.
      • et al.
      Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis.
      Br J Surg. 2007; 94: 198-203
      ]. However, it might have decreased efficacy in morbidly obese patients [
      • Perez A.R.
      • Moncure A.C.
      • Rattner D.W.
      Obesity adversely affects the outcome of antireflux operations.
      Surg Endosc. 2001; 15: 986-989
      ,
      • Morgenthal C.B.
      • Lin E.
      • Shane M.D.
      • et al.
      Who will fail laparoscopic Nissen fundoplication? Preoperative prediction of long-term outcomes.
      Surg Endosc. 2007; 21: 1978-1984
      ]. Thus, an increasing number of patients might require a bariatric procedure after previous Nissen fundoplication, whether for weight loss or recurrent reflux [
      • Houghton S.G.
      • Nelson L.G.
      • Swain J.M.
      • et al.
      Is Roux-en-Y gastric bypass safe after previous antireflux surgery? Technical feasibility and postoperative symptom assessment.
      Surg Obes Relat Dis. 2005; 1: 475-480
      ]. We present the case of a morbidly obese patient who had undergone Nissen fundoplication and presented 8 years later desiring bariatric surgery.

      Keywords

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      References

        • Fisher B.L.
        • Pennathur A.
        • Mutnick J.L.
        • et al.
        Obesity correlates with gastroesophageal reflux.
        Dig Dis Sci. 1999; 44: 2290-2294
        View in Article
        • Locke G.R.
        • Talley N.J.
        • Fett S.L.
        • et al.
        Risk factors associated with symptoms of gastroesophageal reflux.
        Am J Med. 1999; 106: 642-649
        View in Article
        • Barak N.
        • Ehrenpreis E.D.
        • Harrison J.R.
        • et al.
        Gastro-oesophageal reflux disease in obesity: pathophysiological and therapeutic considerations.
        Obes Rev. 2002; 3: 9-15
        View in Article
        • El-Serag H.
        The association between obesity and GERD: a review of the epidemiological evidence.
        Dig Dis Sci. 2008; 53: 2307-2312
        View in Article
        • Friedenberg F.K.
        • Xanthopoulos M.
        • Foster G.D.
        • et al.
        The association between gastroesophageal reflux disease and obesity.
        Am J Gastroenterol. 2008; 103: 2111-2122
        View in Article
        • Ikramuddin S.
        Surgical management of gastroesophageal reflux disease in obesity.
        Dig Dis Sci. 2008; 53: 2318-2329
        View in Article
        • Lundell L.
        • Miettinen P.
        • Myrvold H.E.
        • et al.
        Continued (5-year) followup of a randomized clinical study comparing antireflux surgery and omeprazole in gastroesophageal reflux disease.
        J Am Coll Surg. 2001; 192: 172-181
        View in Article
        • Anvari M.
        • Allen C.
        Five-year comprehensive outcomes evaluation in 181 patients after laparoscopic Nissen fundoplication.
        J Am Coll Surg. 2003; 196: 51-59
        View in Article
        • Mahon D.
        • Rhodes M.
        • Decadt B.
        • et al.
        Randomized clinical trial of laparoscopic Nissen fundoplication compared with proton-pump inhibitors for treatment of chronic gastro-oesophageal reflux.
        Br J Surg. 2005; 92: 695-699
        View in Article
        • Mehta S.
        • Bennett J.
        • Mahon D.
        • et al.
        Prospective trial of laparoscopic Nissen fundoplication versus proton pump inhibitor therapy for gastroesophageal reflux disease: seven-year follow-up.
        J Gastrointest Surg. 2006; 10: 1312-1317
        View in Article
        • Kelly J.J.
        • Watson D.I.
        • Chin K.F.
        • et al.
        Laparoscopic Nissen fundoplication: clinical outcomes at 10 years.
        J Am Coll Surg. 2007; 205: 570-575
        View in Article
        • Lundell L.
        • Miettinen P.
        • Myrvold H.E.
        • et al.
        Seven-year follow-up of a randomized clinical trial comparing proton-pump inhibition with surgical therapy for reflux oesophagitis.
        Br J Surg. 2007; 94: 198-203
        View in Article
        • Perez A.R.
        • Moncure A.C.
        • Rattner D.W.
        Obesity adversely affects the outcome of antireflux operations.
        Surg Endosc. 2001; 15: 986-989
        View in Article
        • Morgenthal C.B.
        • Lin E.
        • Shane M.D.
        • et al.
        Who will fail laparoscopic Nissen fundoplication?.
        Surg Endosc. 2007; 21: 1978-1984
        View in Article
        • Houghton S.G.
        • Nelson L.G.
        • Swain J.M.
        • et al.
        Is Roux-en-Y gastric bypass safe after previous antireflux surgery?.
        Surg Obes Relat Dis. 2005; 1: 475-480
        View in Article
        • Raftopoulos I.
        • Awais O.
        • Courcoulas A.P.
        • et al.
        Laparoscopic gastric bypass after antireflux surgery for the treatment of gastroesophageal reflux in morbidly obese patients: initial experience.
        Obes Surg. 2004; 14: 1373-1380
        View in Article
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        • et al.
        Anatomic findings and outcomes after antireflux procedures in morbidly obese patients undergoing laparoscopic conversion to Roux-en-Y gastric bypass.
        Surg Obes Relat Dis. 2007; 3: 52-57
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        Obes Surg. 1997; 7: 479-484
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        • et al.
        Symptomatic improvement in gastroesophageal reflux disease (GERD) following laparoscopic Roux-en-Y gastric bypass.
        Surg Endosc. 2002; 16: 1027-1031
        View in Article
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        • Davis D.G.
        • Khajanchee Y.
        • et al.
        Comparison of objective outcomes following laparoscopic Nissen fundoplication vs laparoscopic gastric bypass in the morbidly obese with heartburn.
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        • et al.
        Amelioration of gastroesophageal reflux symptoms following Roux-en-Y gastric bypass for clinically significant obesity.
        Am Surg. 2005; 71: 950-954
        View in Article
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        Gastroesophageal reflux disease in morbid obesity: the effect of Roux-en-Y gastric bypass.
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        View in Article

      Article info

      Publication history

      Published online: November 17, 2008
      Accepted: November 3, 2008
      Received in revised form: November 3, 2008
      Received: May 17, 2008

      Identification

      DOI: https://doi.org/10.1016/j.soard.2008.11.004

      Copyright

      © 2009 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

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