Robotic-Assisted Recurrent Hiatal Hernia Repair, takedown of Nissen Fundoplication and Conversion to Roux-en Y Gastric Bypass

Federico Serrot, MD1, Julia Samame, MD1, Matthew Apel, MD1, Hannah Loebl, MS2, Iman Ghaderi, MD1, Carlos Galvani, MD1. 1Banner University Medical Center, 2University Of Arizona, College of Medicine

Introduction: Hiatal hernia repair is reported to have an increased recurrence rate in morbidily obese patients. This video describes a case of Robotic assisted recurrent hiatal hernia repiar, takedown of Nissen fundoplication and conversion to Roux-en Y Gastric Bypass. 

Methods and Procedures: The pre operative workup included EGD, esophageal manometry and 24-hours impedance-pH study. 

Results: 38 year old female with BMI 36.1, s/p repair of hiatal hernia in 2012 having a BMI of 35 kg/m2, who presented with complains of recurrent heart burn, regugitation and dysphagia. Patient was evaluated and found to have recurrence of hiatal hernia and DeMeester score of 108. 

The Operative Time was 176 min, EBL 20 cc. No complications were observed. Patient was discharged home on post operative day 2.

Conclusions: Robotic-assisted recurrent hiatal hernia repair with conversion to Roux-en Y Gastric Bypass is a feasible procedure and an adequate treatment option for morbidly obese patients. 

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