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Laparoscopic repair of incarcerated paraesophageal hernia involving the Gastric pouch, Roux limb, and portion of the Remnant Stomach with mesenteroaxial volvulus

Erik Madden, MD, Patrick Roush, MD, Andrew Wheeler, MD, Rama Ganga, MD. University of Missouri

Roux-en-Y gastric bypass is a long-standing option for management of morbid obesity but can present unique surgical challenges.  This video highlights the presentation and management of an unusual complication:  an acute paraesophageal hernia containing the gastric pouch & roux limb, and a portion of the remnant stomach with a mesenteroaxial volvulus.

The patient is a 42-year-old woman with history of Roux-en-Y gastric bypass five years prior.  She presented with acute epigastric pain, nausea and vomiting.  Imaging and subsequent laparoscopy revealed this unique combination of herniated structures.  To our knowledge, this is the first reported case detailing this specific combination of findings.  The video submitted demonstrates the laparoscopic reduction and repair and highlights a surgical option for management of this rare complication.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95473

Program Number: V416

Presentation Session: Video Loop Day 4

Presentation Type: VideoLoop

59

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