Laparosocpic Nissen fundoplication with the excluded stomach for Recalcitrant GERD after a Roux en Y gastric bypass

Background: The patient is a 63 y/o white female who had undergone a roux en y gastric bypass 10 years prior. Patient had excellent weight loss, however the patient had significant reflux which was managed with PPI's. The patient 3 years ago underwent a lenthening of the roux limb for presumed bile reflux, however the patient continued to complain of significant reflux. She was then referred to us. The patient underwent a manometry which demonstrated good esophageal motility. Her impedence probe was significant for non acid reflux which was abnormal for total number of reflux episodes both supine and recumbent and associated with her symptoms.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research