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Background

Obesity has become a worldwide health epidemic over the last couple decades. With the rise in obesity, use of bariatric surgery has become increasingly common with the sleeve gastrectomy as the most common bariatric surgery performed worldwide. While the sleeve gastrectomy has been efficacious for weight loss, there is increasing concern for the worsening or development of de novo gastroesophageal reflux disease post-operatively. We report a case of a patient with a history of sleeve gastrectomy who had reflux symptoms refractory to medical management but was not deemed an optimal candidate for conversion to Roux-En-Y gastric bypass.

Methods

42 year old female with history of sleeve gastrectomy who presented with severe refractory gastroesophageal reflux symptoms after 70 pound weight loss.

Results

Robotic assisted laparoscopic hiatal hernia repair with modified Hill fundoplication was performed. Follow-up demonstrated near resolution of reflux symptoms.

Conclusions

Clinicians who have patients with a history of sleeve gastrectomy and refractory reflux symptoms can consider use of a modified Hill fundoplication over other fundoplication techniques or conversion to Roux-En-Y gastric bypass for treatment of refractory reflux.