Second-stage robot-assisted biliopancreatic diversion with duodenal switch after sleeve gastrectomy

Obes Surg. 2015 Jan;25(1):197-8. doi: 10.1007/s11695-014-1494-5.

Abstract

Biliopancreatic diversion (BPD) was initially described in 1979 and consisted of a distal gastrectomy with a 250-mL stomach pouch and a distal intestinal bypass with a 50 to 100-cm common channel resulting in malabsorption of dietary fat (Scopinaro et al. Br J Surg. 66(9):618-20, 1979). Later, several modifications (sleeve gastrectomy, pylorus preservation, and duodenal switch) were proposed to improve incidence of postoperative dumping syndrome, diarrhea, and anastomotic ulcerations (Lagacé et al. Obes Surg. 5(4):411-8, 1995). Gagner et al. developed a simplified and reproducible approach for laparoscopic BPD with duodenal switch (BPD-DS) after sleeve gastrectomy (Ren et al. Obes Surg. 10(6): 514-23, 2000). BPD-DS has been considered as one of the most difficult bariatric procedures for its surgical complexity and postoperative metabolic complications management. In this regard, the number of BPD-DS has remained extremely low (<4 %). We hypothesize that robotic approach could facilitate the feasibility of BPD-DS procedure. In this multimedia video (8 min), we present a step-by-step robotic BPD-DS.

Publication types

  • Video-Audio Media

MeSH terms

  • Adult
  • Aged
  • Anastomosis, Surgical / adverse effects
  • Biliopancreatic Diversion / instrumentation*
  • Biliopancreatic Diversion / methods*
  • Dumping Syndrome / etiology
  • Dumping Syndrome / prevention & control
  • Feasibility Studies
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / methods
  • Humans
  • Incidence
  • Jejunoileal Bypass / adverse effects
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Robotic Surgical Procedures*