On April 22 at 4pm (Abu Dhabi Time), AIS Channel will be broadcasting this procedure performed by Dr. Ricard Corcelles (UAE) and his team at Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.
Clinical History:
Clinical Background
47-year-old male patient presenting with intractable bile reflux and marginal ulceration 2 years after an OAGB performed in an outside hospital
Admitted from the ER for severe epigastric pain. Initial EGD showed a large marginal ulcer at the GJ with signs of chronic reflux and ischemia. Patient was placed on anti-acid medications and full PPIs
Readmitted 2 times for the same reason
Technique Description
Other History:
Active smoker. Was placed in the smoking cessation clinic for 8 weeks before planning the elective procedure
Surgery was scheduled 6 months after he first came to the Emergency Room. The intervention was deferred after confirmation of ulcer improvement and negative smoking test
47 years old, male
BMI 38
Procedure Steps:
Identification of the anatomy
Fashioning of gastric pouch
Complete En-bloc resection of the previous loop anastomosis
Creation of the Gastro-Jejunal anastomosis
Roux-en-Y reconstruction
Side-to side jejunojejunostomy
Learning Points:
Importance of identifying the anatomy in a revisional surgery
Routine use of endoscopic assistance (specially in a revisional case)
Complete resection of the previous GJ anastomosis
Measuring the lengths of both afferent and efferent limbs
Constructing a tension-free anastomosis
Closure of the mesenteric and pseudo-Petersen defects
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