Laparoscopic Esophagojejunostomy With Roux-en-Y Reconstruction For Chronic Fistula

Laparoscopic esophagojejunostomy with Roux-en-Y reconstruction for chronic fistula following after sleeve gastrectomy to a 38 year old female. Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance as the preferred option for treating obesity. Risks of leak and subsequent fistula after sleeve gastrectomy still present significant concerns in clinical practice. En-bloc resection of the fistula with proximal gastrectomy and Roux-en-Y esophagojejunostomy is a surgical option to treat chronic staple line leakage when non-operative therapy is rendered ineffective. Most of fistulas are asymptomatic or treated non-operatively for long periods of time. A symptomatic leak requires immediate operation regardless of the time interval between the primary sleeve operation and appearance of the leak. Video by Fredrick Che, MD, Christopher S Armstrong, MD, Ninh T Nguyen, MD.