Laparoscopic Repair of a Staple-line Disruption after an Open Uncut Roux-en-Y Gastric Bypass

The technique of gastric bypass has undergone an evolution over the last 20 years, although it is often individualized based on surgeon preference. Whereas many surgeons divide and separate the gastric pouch from the distal bypassed stomach, some surgeons choose to staple, but not cut and separate the pouch. Staple-line failure resulting in a gastrogastric fistula and weight regain is a worrisome complication. We discuss a case of a patient with an obvious staple-line failure, which resulted in complete weight regain. She underwent laparoscopic repair and was discharged on postoperative day 1. Laparoscopic repair of a staple-line disruption after an open uncut gastric bypass is feasible. Presented at the World Congress of the International Federation for the Surgery of Obesity, Sydney, Australia, August 31, 2006.