Background

This video demonstrates a robotic conversion of Vertical Band Gastroplasty (VBG) withgastro-jejunostomy (GJ) to RYGB. The patient had an open VBG done 30 years ago that was supposedlyconverted to RYGB. She presented to us with abdominal pain. Pre-operative studies showed that the GJwas performed along the greater curvature of the stomach distal to the band with large marginal ulcer.After taking down the adhesions, the Roux limb was divided distal to the gastro-jejunal anastomosis. TheGJ was transected tangentially, leaving the stomach in place. The gastric pouch was then createdproximal to the previous VBG band, preserving the left gastric bundle. A new vertical staple line wascreated, medial to the old one, separating the pouch from the excluded stomach. A new gastro-jejunalanastomosis was created. The video shows the anatomy and dissection facilitated with the use of therobot.