Revision of Laparoscopic Roux-en-Y Gastric Bypass to Laparoscopic Sleeve Gastrectomy with Proximal Jejunal Bypass and Hiatal Hernia Repair

Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a widely performed bariatric procedure. However, post-surgical complications such as marginal ulcers, dumping syndrome, or malabsorption may develop. As a sleeve-plus procedure, laparoscopic sleeve gastrectomy with proximal jejunal bypass (LSGPJB) is considered a simple and effective alternative with lower complications. Herein, we submit a video presentation of a revision of a LRYGB to a LSGPJB in a patient who developed dumping syndrome following LRYGB surgery. Methods The patient is a 51-year-old female who had undergone an LRYGB procedure 11 years ago for obesity III (initial BMI 44.3 kg/m(2)). However, the patient developed dumping syndrome and suffering from abdominal pain and diarrhea immediately after meals. Bilateral leg edema was noted, and diuretics were prescribed by the physician. Preoperative laboratory tests revealed anemia, hypoalbuminemia, and hypokalemia. Subsequently, revision of the LRYGB to LSGPJB was performed. Results The procedure lasted 214 min, without intraoperative complications. Blood loss amounted to 50 mL. The patient's post-operative course was smooth, with a 4-day hospital stay. Remission of the dumping syndrome and hypoalbuminemia was achieved after the surgery. Conclusions Revision of LRYGB to LSGPJB is a safe and feasible procedure for patients who develop post-LRYGB complications such as dumping syndrome or malabsorption.