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Laparoscopic modified Nissen fundoplication over Roux-en-Y gastric bypass and hiatal hernia repair for intractable gastroesophageal reflux
Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity and gastroesophageal reflux disease (GERD) [1] Despite majority of patients with resolution of GERD after RYGB, some patients will continue to complain of significant, persistent reflux symptomatology or develop de novo symptoms despite aggressive medical management. Its true incidence is unknown and 1 study showed an improvement in GERD but not resolution in 22% of patients after RYGB with GERD [2]. Possible mechanisms may include primary lower esophageal sphincter incompetence, disruption of the angle of His, or development of hiatal hernia with intrathoracic migration of the gastric pouch.Laparoscopic resection of intussusception after Roux-en-Y gastric bypass: comparison between the conventional and a simplified approach
Intussusception after Roux-en-Y gastric bypass (RYGB) is a rare, long-term complication most commonly occurring in a retrograde fashion just distal to the jejunojejunostomy with approximately .5% incidence [1]. Management options include reduction, pexy, and resection of jejunojejunostomy [2–4]. Our traditional approach in management of symptomatic intussusception is resection and creation of new jejunojejunostomy,y preferably end-to-side anastomosis with a smaller anastomosis of <60 mm. In this video, we compare 2 techniques used to resect the anastomosis.5-year outcomes of 1-stage gastric band removal and sleeve gastrectomy
No verdict has been reached on single-stage removal of gastric banding with sleeve gastrectomy.Laparoscopic hand sewn regastrojejunostomy for complicated Roux-en-Y gastric bypass
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a popular bariatric procedure associated to potential risk of late complications like anastomotic marginal ulceration, stricture, fistula formation, weight gain, and nutritional deficiencies [1–6].The case of being in the wrong place at the wrong time: the consequences of undiagnosed anatomic anomalies
The number of laparoscopic bariatric surgery procedures is continuing to rise owing to the increasing number of obese patients fulfilling the eligibility criteria [1]. We present a case of failed gastric banding with subsequent sleeve gastrectomy owing to the intraoperative finding of unexpected anatomic anomalies.Laparoscopic revision of biliopancreatic diversion with duodenal switch and management of postoperative complications
Biliopancreatic diversion with duodenal switch (BPD-DS) is a bariatric operation with restrictive and malabsorptive effects. It includes sleeve gastrectomy with division of the first portion of the duodenum and reconnection to the distal 250 cm of ileum. The bypassed duodenum, jejunum, and proximal ileum (biliopancreatic limb) are reconnected to create a Y-shaped anatomy with a common channel of 50–150 cm.
