Background

Patient is a 39 year old female with a past surgical history of a sleeve gastrectomy performed three and a half years ago in Mexico. This operation was complicated by a gastric perforation at the cardia. She presented to our clinic with left-sided chest pain, recurrent cough and occasional hemoptysis. A computed tomography of the abdomen and pelvis and an upper gastrointestinal series were performed, revealing a gastro-pleural fistula. The patient subsequently was taken to the operating room for a robotic assisted laparoscopic gastro-pleural fistula takedown with Roux-en-Y reconstruction. This video demonstrates the surgical steps of a gastro-pleural fistula takedown and Roux-en-Y reconstruction. A two layered hand-sewn gastrojejunostomy and incorporated jejunal serosal patch of the gastric defect from the fistula was performed. The patient had an uneventful course and was discharged on post-operative day two. Five months post-op the patient has no known complications or hospital readmissions.