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Laparoscopic conversion from mini gastric bypass/1 anastomosis gastric bypass to Roux-en-Y gastric bypass for perforated marginal ulcer: video case report
In 1997, Rutledge [1] introduced a new bariatric procedure consisting of a single anastomosis gastric bypass, which he named a mini gastric bypass (MGB).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.Simplified laparoscopic Hill repair for the treatment of symptomatic sliding hiatus hernia after bariatric surgery
Sliding hiatus hernia (SHH) is a frequent condition associated with obesity [1]. After Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), SHH may be asymptomatic, may predispose to gastroesophageal reflux disease (GERD) [2], and occasionally may trigger painful dysphagia. The pathophysiology of pain is thought to be related to the rubbing of the gastric staple line on the left diaphragmatic pillar, transmitted by the left phrenic nerve [3].Laparoscopic gastrojejunostomy revision: a novel approach to intractable marginal ulcer management
Marginal ulcers are a known complication after Roux-en-Y gastric bypass, with a variable incidence of .6–16% [1,2]. Initial therapy involves elimination of the inciting risk factors [3] and medical management with a proton pump inhibitor and sucralfate therapy [4]. Although most marginal ulcers will heal with such treatment, approximately one third of patients will require operative intervention [5]. Surgery typically involves total revision of the gastrojejunostomy [6]. Revisional bariatric surgery, however, is technically difficult and has been associated with high morbidity and mortality rates.
