Background

This is a video submission showing the conversion of a Nissen fundoplication to a Roux-en-Y gastric bypass in a patient with a BMI of 33 and history of T1a Esophageal Adenocarcinoma. The patient history is discussed below. The patient is a 50-year-old male with history of GERD, Barrett's Esophagus with high grade dysplasia and T1a Esophageal Adenocarcinoma. In 2017 he underwent multiple Radio Frequency ablations and a Laparoscopic Nissen Fundoplication. He was referred back to our clinic for discussion of further intervention. During his preoperative work-up he was found to have a recurrence of his hiatal hernia and worsening of his gastroesophageal reflux disease symptoms. In the following video we will show you how we reduced his herniated fundoplication, performed a cruroplasty and then converted his fundoplication to a Roux-en-Y gastric bypass. Since the operation the patient has been doing well and recovered without issue. His GERD symptoms have since resolved and he will continue with his regular surveillance esophagogastroduodenoscopies and intervention as warranted.