Laparoscopic Roux-en-Y Gastric Bypass for Severe Gastroesophageal Reflux after Vertical Banded Gastroplasty

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Abstract
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). 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. 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.

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