Background

The case demonstrated in this video is of a patient with a history of sleeve gastrectomy and paraesophageal hernia repair. She presented to our institution with symptoms of acid reflux and was found to have a recurrent paraesophageal hernia. She declined conversion to roux-en-Y gastric bypass (RnYGB) and instead elected for redo paraesophageal hernia repair with placement of a magnetic sphincter augmentation (MSA) device as an anti-reflux procedure due to lack of a fundus. Unfortunately, one year following this repair, she developed symptoms of dysphagia and workup demonstrated a recurrent paraesophageal hernia and slipped MSA device. She was advised to undergo conversion to RnYGB, but again declined, so she underwent a third paraesophageal hernia repair and removal of the slipped MSA device. The procedure was performed via robotics platform.