Laparoscopic Resection of a Post Roux-en-Y Gastrogastric Fistula

Kelly R Haisley, MD, Samer Mattar, MD, Gene Bakis, MD, Laura Fischer, MD. Oregon Health and Science University

Gastrogastric fistula (GGF) is a well-known complication of Roux-en-Y gastric bypass (RYGB), occurring in 1-6% of the greater than 25,000 RYGBs performed in the United States every year. When they occur, GGFs can cause persistent pain, refractory ulcers and weight regain, creating significant negative impacts on quality of life. When medical and endoscopic approaches fail, are unavailable, or are inappropriate for a given patient, surgical intervention becomes necessary. As shown in the video, the most definitive operation involves resection of the GGF complex in its entirety (gastric pouch, excluded stomach and often the proximal aspect of the roux limb) and recreation of the gastrojejunal anastomosis. 

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