Background

Gastro-gastric fistula (GGF) after a Roux-en-Y Gastric Bypass (RNYGB) is an abnormal connection between the gastric pouch and gastric remnant. This complication is rare following a RNYGB and symptoms can include weight regain, Gastroesophageal Reflux Disease (GERD) and upper abdominal pain. Initial treatment is medical, however, surgical repair may be indicated, especially when the fistula is symptomatic, large or complex. We present a case of a 40-year-old woman with a remote history of open RNYGB for morbid obesity complicated by recurrent gastro-gastric fistulae. Her symptoms of post-prandial epigastric pain and GERD were evaluated with an outpatient Upper GI contrast study and CT abdomen/pelvic with oral contrast that revealed an abnormal communication between the gastric-jejunal anastomosis and remnant stomach. This case report of a robotic-assisted, laparoscopic revision of Roux-en-Y gastric bypass for recurrent GGF demonstrates the safety and efficacy of robotic surgery in complex revisional bariatric procedures.