Abstract:
PURPOSE:Laparoscopic gastric bypass (LRYGB) is considered as the gold standard procedure for morbid obesity because of sustainable weight loss and coexisting conditions improvements (Sjostrom L et al. The New England journal of medicine 351(26):2683-93, 2004 [1]; Thereaux J et al. Surg Obesity Related Dis: Off J Am Soc Bariatric Surg, 2014 [2]). However, there are some concerns with the late risk of gastrojejunal anastomotic stenosis and of small bowel obstruction (Hamdan K et al. 98(10):1345-55, 2011 [3]). MATERIALS AND METHODS:We present the case of a 46-year-old woman (70 kg, 1.67 m) with a body mass index (BMI) of 25.1 kg/m(2) who had undergone LRYGB, 3 years ago (initial BMI 45 kg/m(2)). She was referred to our tertiary care center for dysphagia and abdominal pain. RESULTS:In this multimedia video, we present a step-by-step laparoscopic revision of a LRYGB for gastrojejunal anastomotic stenosis associated with trans-mesocolic defect. Procedure included dissection and resection of the strictured anastomosis, redo gastrojejunal circular anastomosis, and closure of the trans-mesocolic defect. No adverse outcomes occurred during the postoperative period. CONCLUSION:Gastrojejunal anastomosis stenosis should be managed under laparoscopy. All abdominal surgery in patients with a history of LRYGB, especially with trans-mesocolic alimentary limb, should include inspection of potential meso-defect.
journal_name
Obes Surgjournal_title
Obesity surgeryauthors
Thereaux J,Roche C,Bail JPdoi
10.1007/s11695-015-1616-8subject
Has Abstractpub_date
2015-05-01 00:00:00pages
948issue
5eissn
0960-8923issn
1708-0428journal_volume
25pub_type
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