Laparoscopic Roux-en-Y gastric bypass after vertical banded gastroplasty
Epublication WebSurg.com, Apr 2009;09(04). URL: http://websurg.com/doi/vd01en2596
Patients who have undergone bariatric surgery and present with upper abdominal symptoms pose a diagnostic and management challenge. Laparoscopic vertical banded gastroplasty (VBG) is associated with high revisional rates. In the case of failed VBG, repeat VBG seems to be a poor option and conversion to gastric bypass yields better results. This is the case of a 35-year-old female patient who underwent a vertical banded gastroplasty by laparotomy 8 years ago and presents with dysphagia. A gastroscopy and a contrast swallow exam using radio-opaque markers do not show any fistulas, but peroperative surgical exploration discovers a gastro-gastric fistula. This video clearly shows all the technical aspects of a revisional bariatric procedure.