Robotic-assisted Roux-en-Y Gastric Bypass Reversal due to Dumping Syndrome and Severe Malnutrition

Roberto E. Bustos, MD; Valentina Valle, MD; Gabriela M. Aguiluz, MD; Alberto Mangano, MD; Mario Masrur, MD, FACS

Product Details
Product ID: ACS-5708
Year Produced: 2019
Length: 8 min.


Although Roux-en-Y gastric bypass is one of the most commonly performed procedures for morbidly obese patients, it carries the risk of potential complications such as dumping syndrome and severe malnutrition. In this situation, a gastric bypass reversal is a valid option, but always considering the risk of weight regain and return of comorbidities. 43-year-old female. History of Roux-en-Y gastric bypass 9 years prior. BMI 18 kg/m2. HPI: dumping syndrome, severe malnutrition with no clinical improvement despite proper medical and nutritional therapy. A robotic-assisted reversal of Roux-en-Y gastric bypass was planned. An extensive adhesiolysis was required to gain access to the surgical site. Previous anastomoses were mobilized and taken down. Normal transit was restored creating 2 jejuno-jejunostomies (using a laparoscopic linear stapler) and 1 gastro-gastrostomy (using a laparoscopic 28mm circular stapler). The robotic platform has a potential role in operations are traditionally done open. Extensive adhesiolysis is possible using the robotic instruments and anastomosis can be created using robotic staplers, laparoscopic staplers, or hand-sewn if required.