Background

History of Present Illness: Patient is a 25 yo female s/p laparoscopic Sleeve Gastrectomy performed in September 2017. Patient initial weight was 365 lbs (BMI=55). On presentation patient weight was 391 lbs (BMI=59). Patient reported no GERD, dysphagia or regurgiattaion. Work up included UGI and EGD which showed normal postoperative appearance without hiatal hernia, esophagitis or barrett's esophagus. Patient was consented for sleeve conversion to SADI. Video represents our retrogastric technique in dissecting the duodenum in order to perform a Single Anastomosis Duodenal-Ileostomy using a Robotic Approach.