Robotic TEP Mesh Repair of Hernia

Full length video of re-do gastric sleeve after gastric band conversion to sleeve gastrectomy

The patient underwent gastric band surgery revised once seven years prior. The gastric band surgery was converted elsewhere to a sleeve gastrectomy in two consecutive operations eight years ago. The patient failed to lose any weight after the band or the sleeve but continued to complain of reflux; a moderate size hiatus hernia was demonstrated on radiological studies and endoscopy. The surgery is revised and the hiatus hernia is repaired in this video, with view to a second stage gastric by-pass. The patient recovered well, with minimal discomfort and was discharged day one after surgery.

Gastric Leak treatment with oeso-gastric stent in my practice

The video below (with patient permission) shows a patient day one after stenting when she presented with a leak at the COJ and a subphrenic collections on day seven after re-do sleeve gastrectomy. The collection was drained percutaneously and the patient was discharged on day seven without need of surgery or intensive care. She tolerated the stent well at home and, three weeks later was readmitted overnight for stent removal.

Several of my patients had leaks managed with stents following revisional surgery, primary gastric sleeve or band erosion with closure of the leak in 2-4 weeks and no added morbidity from the stent. The patients were managed exclusively by myself.

The picture on the left shows the placement of the stent, rapid normalisation of the vitals and the subphrenic collections drained two days later percutaneously.