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surgical intervention video

Roux-en-Y gastric bypass (RYGB) has become a common procedure for the management of morbid obesity. However, learning to perform such a procedure may be difficult as it is made up of very technical operative steps in complex cases of overweight patients with a great amount of adipose tissue. In order to prevent complications, an operative strategy should be adopted, allowing for an easy and rapid acquisition of the technique. Each step is perfectly mastered and outlined. 

This video demonstrates a laparoscopic Roux-en-Y gastric bypass performed live, showing all the preoperative and operative patient settings. The surgical technique is thoroughly explained. 

Laparoscopic Roux-en-Y gastric bypass: live demonstration and technical details

Bypass gástrico en Y de Roux laparoscópico: demostración en vivo y detalles técnicos


Bypass gastrique laparoscopique avec anse en Y : démonstration en direct et détails techniques


Лапароскопическое шунтирование желудка по Ру: демонстрация операции с описанием технических нюансов


腹腔镜Roux-en-Y胃旁路术：现场演示和技术细节


Bypass gástrico em Y de Roux laparoscópico: demonstração ao vivo e detalhes técnicos


Patients ask for a new weight loss surgical procedure after gastric band removal due to a lack of efficiency or to complications. Although gastric banding is a reversible procedure, perigastric adhesions located mostly in the upper part of the stomach can make new approaches to this area difficult. 

We report the case of a woman who benefited from a gastric banding in 2006. This gastric band was removed in 2010. The patient developed a left subphrenic abscess, which was drained under CT-scan control postoperatively. 

Two years after this procedure, the patient wishes to benefit from a new weight loss surgical procedure as she gained 10Kg since her gastric band removal. She has a BMI of 40 and presents with respiratory and rheumatological co-morbidities. 

The preoperative work-up was uneventful, and this is particularly true for the esogastroduodenal contrast exam and the gastroscopy. 

During the procedure, multiple omental parietal adhesions were found, as well as tight adhesions between the liver, the stomach, and the left crus. 

Dissecting the stomach using a conventional approach was made difficult by the presence of these adhesions, and we had to perform an upper pole gastrectomy of the greater curvature in order to clearly identify the gastroesophageal junction’s anatomy. A complete dissection of the left subcardial area is necessary in order to prevent the formation of an excessively large gastric pouch, which could lead to a regain in weight. 

This video covers the whole procedure in detail and highlights dissection challenges, which can occur in patients who had their gastric band removed. 

The postoperative outcome was uneventful in this woman, with a significant weight loss at one year. 

Robot-assisted Roux-en-Y gastric bypass after band removal

Bypass gástrico en Y de Roux asistido por robot después de retirada de la banda


机器人辅助的Roux-en-Y胃旁路手术


Робот-ассистированное шунтирование желудка по Ру после удаления желудочного бандажа


Bypass gástrico em Y de Roux assistido por robô após remoção da banda


Bypass gastrique avec anse en Y robot-assisté après ablation d'anneau gastrique


Retirada de la banda gástrica asistida por robot


Ablation d'un anneau gastrique : technique robot-assistée


机器人辅助胃带去除


Remoção da banda gástrica assistida por robô


Adjustable gastric banding (AGB) is one of the surgical treatment modalities for morbid obesity. Over the years, popularity for this treatment increased. It has been by far the most performed bariatric procedure for years in Europe and in the United States. Many gastric band removals are linked to complications and weight loss failure, indicating a new bariatric procedure for some of the patients. Complications after AGB are not uncommon and consist mainly of gastroesophageal reflux disease, pouch dilatation, slippage of the band, and intragastric migration. The failure of the gastric band is multifactorial. Gastric band removal does not preclude a new bariatric procedure (the most common procedure performed in our department is Roux en-Y gastric bypass), which is feasible in the same operative time but the 2-step approach is suitable. The new bariatric procedure offers adequate surgical outcomes and satisfactory results in terms of weight loss. 

Robot-assisted gastric band removal 

Робот-ассистированное удаление желудочного бандажа


video lecture

Nesta palestra magistral, o Dr. Pattou se concentra nas novas fronteiras da cirurgia metabólica, da diabete tipo 2 à esteato-hepatite não alcoólica (NASH).


Novas fronteiras na cirurgia metabólica, da diabete tipo 2 à esteato-hepatite não alcoólica (NASH)

Nouvelles frontières en chirurgie métabolique du diabète de type 2 à NASH


In this key lecture, Dr. Pattou focuses on the new frontiers in metabolic surgery, from type 2 diabetes to NASH.

New frontiers in metabolic surgery from type 2 diabetes to NASH

Nesta palestra magistral, o Dr. Himpens se concentra no que deveria ser feito e quando deveria ser realizada.


Operações de perda de peso: qual e quando?

In this key lecture, Dr. Himpens focuses on what should be done and when should it be performed.

Weight loss operations: what and when?

Opérations de perte de poids : quoi et quand ? 


Nesta palestra magistral, o Dr. Pattou cobre os mecanismos de ação do bypass gástrico.


Bypass gástrico: mecanismos de ação

Pontage gastrique : mécanismes d'action


In this key lecture, Dr. Pattou covers the mechanisms of action of the gastric bypass.

Gastric bypass: mechanisms of action

Nesta palestra magistral, o Dr. Himpens se concentra na reversão à anatomia normal adicionando gastrectomia vertical.


Reversão à anatomia normal adicionando gastrectomia vertical

Retour à l'anatomie normale en ajoutant la sleeve gastrectomie


In this key lecture, Dr. Himpens focuses on reversal to normal anatomy adding sleeve gastrectomy.

Reversal to normal anatomy adding sleeve gastrectomy

Prise en charge de sténoses après LSG


Nesta palestra magistral, o Dr. Himpens cobre o manejo da estenose, kinking e constrições após gastrectomia vertical laparoscópica.


Manejo da estenose, kinking e constrições após gastrectomia vertical laparoscópica

In this key lecture, Dr. Himpens covers the management of stenosis, kink and strictures after LSG.

Focus On Bariatric Surgery!