• Skip to main content
  • Skip to header right navigation
  • Skip to site footer

Log in
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
www.sages.org

SAGES

Reimagining surgical care for a healthier world

  • Home
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Awards
    • Who Is SAGES?
    • Leadership
    • Our Mission
    • Advocacy
    • Committees
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Committee Rosters
      • SAGES Past Presidents
  • Meetings
    • SAGES NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2026 Scientific Session Call for Abstracts
      • 2026 Emerging Technology Call for Abstracts
    • CME Claim Form
    • SAGES Past, Present, Future, and Related Meeting Information
    • SAGES Related Meetings & Events Calendar
  • Join SAGES!
    • Membership Application
    • Membership Benefits
    • Membership Types
      • Requirements and Applications for Active Membership in SAGES
      • Requirements and Applications for Affiliate Membership in SAGES
      • Requirements and Applications for Associate Active Membership in SAGES
      • Requirements and Applications for Candidate Membership in SAGES
      • Requirements and Applications for International Membership in SAGES
      • Requirements for Medical Student Membership
    • Member Spotlight
    • Give the Gift of SAGES Membership
  • Patients
    • Join the SAGES Patient Partner Network (PPN)
    • Patient Information Brochures
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find A SAGES Surgeon
  • Publications
    • Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Sustainability in Surgical Practice
    • SAGES Stories Podcast
    • Patient Information Brochures
    • Patient Information From SAGES
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • MesSAGES – The SAGES Newsletter
    • COVID-19 Archive
    • Troubleshooting Guides
  • Education
    • Wellness Resources – You Are Not Alone
    • Avoid Opiates After Surgery
    • SAGES Subscription Catalog
    • SAGES TV: Home of SAGES Surgical Videos
    • The SAGES Safe Cholecystectomy Program
    • Masters Program
    • Resident and Fellow Opportunities
      • MIS Fellows Course
      • SAGES Robotics Residents and Fellows Courses
      • SAGES Free Resident Webinar Series
      • Fluorescence-Guided Surgery Course for Fellows
      • Fellows’ Career Development Course
    • SAGES S.M.A.R.T. Enhanced Recovery Program
    • SAGES @ Cine-Med Products
      • SAGES Top 21 Minimally Invasive Procedures Every Practicing Surgeon Should Know
      • SAGES Pearls Step-by-Step
      • SAGES Flexible Endoscopy 101
    • SAGES OR SAFETY Video Activity
  • Opportunities
    • Fellowship Recognition Opportunities
    • SAGES Advanced Flexible Endoscopy Area of Concentrated Training (ACT) SEAL
    • Multi-Society Foregut Fellowship Certification
    • Research Opportunities
    • FLS
    • FES
    • FUSE
    • Jobs Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • OWLS/FLS
You are here: Home / Abstracts / Minimally invasive conversion of sleeve gastrectomy to Roux-en-Y Gastric Bypass for Intractable Gastroesophageal Reflux Disease: Short Term Outcome

Minimally invasive conversion of sleeve gastrectomy to Roux-en-Y Gastric Bypass for Intractable Gastroesophageal Reflux Disease: Short Term Outcome

Lauren M Kastner, Dr, Stephen Leeds, Dr, Daniel Davis, Dr. Baylor University Medical Center Of Dallas

Background: Surgical management recommendations for intractable gastroesophageal reflux disease (GERD) after sleeve gastrectomy (SG) remain controversial. This case series demonstrates our experience with treatment of post-operative intractable GERD using minimally invasive conversion of SG to Roux-en-Y gastric bypass (RYGB). 

Patients and Methods: This is a retrospective review of a prospective data registry (MBSAQIP) from Jan 2016 through Sept 2017. Eleven patients, 10 female and 1 male, were evaluated.  Of the 11 surgeries, 7 were laparoscopic, 3 assisted with Xi Da Vinci robot, and 1 assisted with Si Da Vinci Robot. All patients presented with intractable reflux on high dose PPI. Three had a history of aspiration pneumonia. The mean BMI at time of RYGB was 40.7 ± 11.1 kg/m2.  Based on estimated time frames from medical records the mean interval time between sleeve and conversion to RYGB was 48.2 ± 17.3 months.  Upper GI series on all eleven patients performed prior to RYGB showed significant reflux. pH studies were done on 4 patients with a mean DeMeester 43.3, pH < 4 mean time was 16%.  High Resolution Manometry was performed on 3 patients with varied results of esophagogastric junction obstruction, spastic peristalsis, and Ineffective Motility Disorder with abnormal peristalsis.

Results: Mean operative time was 173.3 ± 62.6 minutes.  There were no conversions to open surgery and no mortality.  Mean hospital stay was 2.54 ± 1.21 days. Seven surgeries included a hiatal hernia repair

Five surgeries included laparoscopic fundectomy of the neofundus. All patients reported complete resolution of GERD symptoms. One developed empyema. Three developed stenosis of gastrojejunostomy.  Initial mean BMI was 41.2 ± 11.1 kg/m2.  After a mean follow up of 5.33 ± 2.89 months, mean change in BMI, % total weight loss, and %EBMIL was 8.64 ± 7.17 kg/m2, 13.73 ± 6.56%, 40.1 ± 14.88%, respectively.  One was omitted due to pending results.   

Conclusion: Several solutions exist for operative management of intractable GERD after SG including redo-sleeve gastrectomy, combined gastrectomy with fundoplication, conversion to gastric bypass or anti-reflux procedures such as LINX. Reports remain small in series and require further study to evaluate the consistency of results.  We found minimally invasive conversion of SG to RYGB is a highly effective and safe option for treatment of intractable GERD.  


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

Abstract ID: 88241

Program Number: P549

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

58

Share this:

  • Click to share on X (Opens in new window) X
  • Click to share on Facebook (Opens in new window) Facebook
  • Click to share on LinkedIn (Opens in new window) LinkedIn
  • Click to share on Pinterest (Opens in new window) Pinterest
  • Click to share on WhatsApp (Opens in new window) WhatsApp
  • Click to share on Reddit (Opens in new window) Reddit
  • Click to share on Pocket (Opens in new window) Pocket
  • Click to share on Mastodon (Opens in new window) Mastodon
  • Click to share on Threads (Opens in new window) Threads
  • Click to share on Bluesky (Opens in new window) Bluesky

Related


sages_adbutler_leaderboard

Hours & Info

11300 West Olympic Blvd, Suite 600
Los Angeles, CA 90064

1-310-437-0544

[email protected]

Monday – Friday
8am to 5pm Pacific Time

Find Us Around the Web!

  • Bluesky
  • X
  • Instagram
  • Facebook
  • YouTube

Copyright © 2025 · SAGES · All Rights Reserved

Important Links

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals