SSAT - REVISITING THE SLEEVE: TECHNICAL PEARLS FOR CONVERTING TO ROUX-EN-Y GASTRIC BYPASS WITH CONCURRENT HIATAL HERNIA REPAIR

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REVISITING THE SLEEVE: TECHNICAL PEARLS FOR CONVERTING TO ROUX-EN-Y GASTRIC BYPASS WITH CONCURRENT HIATAL HERNIA REPAIR
Alejandro Feria^*, AJ Haas, Ramiro Cadena Semanate, Amelia Dorsey, Kevin El-Hayek, Sergio Bardaro
Surgery, MetroHealth Medical Center, Cleveland, OH

Gastroesophageal reflux after sleeve gastrectomy classically indicates revision to a roux-en-y gastric bypass. Concomitant hiatal hernia can also cause GERD, thus, hiatal hernia repair is also indicated. This presents a complex technical challenge: achieving a safe and effective hiatal hernia repair in a re-operative field, avoiding damaging privileged mediastinal structures, and preserving the sleeve without sabotaging conversion to a roux-en-y gastric bypass.

Here we describe the surgical management and technical considerations of a late postoperative hiatal hernia associated with GERD after sleeve gastrectomy, which was repaired laparoscopically and converted to a roux-en-y gastric bypass.

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