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Sleeve gastrectomy in patients with previous antireflux surgery. Preliminary results of the “no-touch to posterior wrap” technique
Reported morbidity of Roux-en-Y gastric bypass in patients with previous antireflux surgery warrants caution, and data on sleeve gastrectomy (SG) are unexpectedly scarce.Robotic-assisted conversion of Nissen fundoplication to Roux-en-Y gastric bypass (avoiding pitfalls)
Conversion of Nissen fundoplication to Roux-en-Y gastric bypass can be technically challenging due to factors present for any reoperation, such as presence of scar tissue, altered tissue planes, and often unclear anatomy. Meticulous hiatus and wrap dissection, repair of hiatal hernia if present, complete unwrapping of the fundoplication and clarification of gastric redundancy before pouch creation, and preservation of the left gastric artery are keys to improving outcomes and reducing morbidity.
