Laparoscopic Roux-en-Y gastric bypass for severe gastroesophageal reflux after vertical banded gastroplasty.
BACKGROUND
Vertical banded gastroplasty (VBG) is sometimes associated with complications such as pouch obstruction, dilatation, and gastroesophageal reflux. This occasionally requires surgical revision, in many cases to a Roux-en-Y gastric bypass (RYGBP).


METHODS
A 47-year-old woman with severe obesity developed severe symptoms of stenosis of the pouch outlet and gastroesophageal reflux 15 years after VBG. Laparoscopic conversion to a RYGBP was performed. At 9-month follow-up, she lost an additional 32 kg and had complete resolution of her reflux.


CONCLUSIONS
In this patient, laparoscopic re-operative RYGBP produced additional weight loss, and improved gastroesophageal reflux that occurred many years after having a VBG. Laparoscopic conversion of a VBG to RYGBP is feasible, and may confer the benefits of other minimally invasive abdominal procedures to this high-risk patient group.
Bloomberg
Richard D
RD
Minimally Invasive Surgery Program, Toronto Western Hospital, Department of Surgery, University of Toronto, Toronto, ON, Canada.
Urbach
David R
DR
D000713:Anastomosis, Roux-en-Y; D001458:Bandages / Q000009:adverse effects*; D005260:Female; D015390:Gastric Bypass; D005764:Gastroesophageal Reflux / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D015391:Gastroplasty / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D009767:Obesity, Morbid / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012720:Severity of Illness Index