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Second-Stage Robot-Assisted Biliopancreatic Diversion with Duodenal Switch After Sleeve Gastrectomy

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.
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Submitted on : Monday, January 15, 2018 - 4:53:06 PM
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G. Fantola, N. Reibel, A. Germain, A. Ayav, L. Bresler, et al.. Second-Stage Robot-Assisted Biliopancreatic Diversion with Duodenal Switch After Sleeve Gastrectomy. Obesity Surgery, Springer Verlag, 2015, 25 (1), pp.197 - 198. ⟨10.1007/s11695-014-1494-5⟩. ⟨hal-01684671⟩



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