Laparoscopic Repair of Type III Paraesophageal Hernia [PEH], Incidental Repair of Large, Incarcerated Retrocolic Mesocolon Hernia, and Hand-Sewn Revision of Recurrent Gastro-Jejunal Anastomotic Stricture After POSED Not Amenable to Endoscopic Dilatation and Stenting

Excerpt

Studies have demonstrated a small proportion of patients undergoing metabolic bariatric surgery (MBS) may develop esophageal dysmotility postoperatively [1]. While some may be attributed to dysfunction of the lower esophageal sphincter (LES), others are due to proximal gastric obstruction resulting in secondary esophageal dysmotility. The term post obesity surgery esophageal dysmotility (POSED) has been coined to describe these patients and is most commonly due to a stricture of the gastro-jejunal anastomosis (GJA) or narrowing of sleeve gastrectomy [2]. Patients with POSED require a different treatment approach than patients with achalasia or LES dysfunction. We present a patient with a history of RYGB diagnosed with a paraesophageal hernia, stricture at the GJA with POSED not amenable to endoscopic stenting or dilation, and an incidental mesocolon hernia. …