56 years old patient with 54 BMI who had a Bypass surgery for weight loss 32 years ago via open surgery. History of two more open surgeries for gallbladder remove and liver segmentectomy. Hypertension, Diabetes Mellitus and Hypothyroidism under control.
Bypass surgery before works for four years and after that start regaining weight at this days more that she had before the surgery. We begin the surgery laparoscopic via and at the same time do an endoscopy. We found anastomoses in the gastric foundus 3cm under Esofagastric union with all integrity stomach and a Y Roux for bile drain. The patient had a biliopancreatic length of 50cm and alimentary length of 190cm. The length of the limbs was correct, but the patient never had a restriction because she conserve all her stomach. We dissect all scares and do a small gastric punch forgive to her a standard limit and satiety with a capacity of 3oz approx.
The patient had Gastric bypass in the US and during surgery they had to do open surgery. The patient created a hernia along the incision. She had a hernia removed several times. She started gaining weight. When Dr. Lopez did endoscopy, the pouch looked good. They had to do an open surgery. Dr. found out the second anastomosis (y) is enlarged as much as 10 cm acting like a stomach. Doctors reduced it to give patient less absorption so she can lose weight. She is feeling great a day after surgery.