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Robotic Distal Gastrectomy for refractory peptic ulcer disease

Roberto Bustos, MD, Gabriela Aguiluz, MD, Alberto Mangano, MD, Yevhen Pavelko, MD, Luis Gonzalez, MD, Mario Masrur, MD, FACS. University of Illinois at Chicago

Introduction: Adults with Sickle Cell Disease can be at increased risk of H. Pylori-induced Peptic Ulcers. Moreover, these patients can develop complications related to pre-existing chronic anemia, excessive use of NSAIDs, and alloimmunization which in turn may delay transfusion. Despite of the effectiveness of the PPIs and eradication of H. Pylori by antibiotics, surgical treatment is still an option. In particular, this is true when bleeding ulcers are refractory to medical treatment or when malignant ulcers are diagnosed.

Methods: 56-year-old female.  History of sickle cell disease with multiple complications (vaso-occlusive crisis, acute coronary syndrome, recurrent interstitial pneumonia, avascular necrosis of the hip and acute kidney failure). HPI: long-standing peptic ulcer disease with H. Pylori infection and multiple episodes of GI bleed requiring cauterization.

Results: A Robotic-assisted distal gastrectomy with Roux-en-Y reconstruction was performed. An extensive adhesiolysis was required to gain access to the lesser curvature. The gastrojejunostomy was constructed using a linear stapler (purple load). Gastrostomy and enterotomy were closed with a single layer 3-0 PDS running suture.

Conclusions: Surgical treatment for peptic ulcer disease has become less common due to the effectiveness of medical treatment. Nevertheless, in some specific situations, surgical treatment is indicated and minimally invasive approach using the robotic platform is a feasible alternative.


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

Abstract ID: 94525

Program Number: V276

Presentation Session: Video Loop Day 2

Presentation Type: VideoLoop

158

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