Sarah Pearlstein, MD, Dimitar Ranev, MD, Julio Teixeira, MD, Andrew Godwin, MD. Lenox Hill
This is the case of a 35 year old female with history of morbid obesity who underwent vertical sleeve gastrectomy four years ago, followed by inadequate weight loss and subsequent repeat sleeve gastrectomy one year ago. Four months post-operatively she presented with chronic cough and after workup was found to have a gastro-bronchial fistula. Multiple unsuccessful attempts were made to control the fistula including endoscopic stenting, percutatneous drainage, internal drainage and VATS for intrathoracic resection. After failure of these attempts, a jejunostomy tube was placed to improve her malnutrition over the course of two months and then laparoscopic robotic-assisted resection of gastric fistula nad conversion to roux-enY gastric bypass was performed. This video includes the key points of this operation including extensive meticulous dissection into the retroperitoneum near the splenic vessels and complete resection of the fistulous tract. The patient tolerated the procedure well with resolution of symptoms and stabilization of weight at four months post-operatively.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 94883
Program Number: V047
Presentation Session: Bariatric I – Complications
Presentation Type: Video