Background

Vertical banded gastroplasty (VBG) is an uncommonly performed bariatric surgery today. An understanding of VBG anatomy; complications such as dysphagia, poor weight loss, band erosion and gastrogastric fistula; and operative management remains a necessary skill for bariatric surgeons. We present a case of gastrogastric fistula following a remote open VBG managed with laparoscopic conversion of VBG to Roux-en-Y gastric bypass.

Methods

We use intraoperative video to demonstrate the laparoscopic conversion of a vertical banded gastroplasty to Roux-en-Y gastric bypass for gastro-gastric fistula and weight gain. The patient was informed of the risks and benefits of this operation and consented to the procedure as well as the recording and its publication.

Results

Using a standard laparoscopic Roux-en-Y port placement, we were able to safely convert a vertical banded gastroplasty to Roux-en-Y gastric bypass with minimal blood loss. The patient had a two-day hospitalization. By one month post-op, she had lost 31 lbs (BMI 42) and had complications of loose stool, diarrhea, and occasional dumping syndrome. By 3 months post-op, she had lost 66 lbs (BMI 37.8) and improvement in dumping symptoms with lower glycemic intake.

Conclusions

Vertical banded gastroplasty can safely be converted to a Roux-en-Y gastric bypass using a standard laparoscopic Roux-en-Y port placement.