TECHNICAL ASPECTS OF LAPAROSCOPIC REDUCTION OF INTRATHORACIC SLEEVE GASTRECTOMY MIGRATION, HIATAL HERNIA REPAIR, DISTAL GASTRECTOMY AND CONVERSION TO GASTRIC BYPASS.
Renato Roriz-Silva, Yahya Alwatari, Roel Bolckmans, Guilherme M. Campos*
VCU, Richmond, VA
Intrathoracic migration of Laparoscopic Sleeve Gastrectomy (LSG) has been seldom reported, and it is likely associated with failure to properly repair a hiatal hernia at index operation. We present the case of a 43-y female with dysphagia that had a LSG and "anterior" hiatal hernia repair 11 y ago. Pre-operative workup showed an almost complete migration of the LSG into the mediastinum, a partial organo-axial volvulus, and a narrowing at the incisura. The video shows the technical aspects of the laparoscopic reduction of intrathoracic LSG, standard posterior hiatal hernia repair, distal gastrectomy and conversion to gastric bypass. The patient is asymptomatic at two years of follow-up.
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