Background

We present the technical details of emergency Laparoscopic Repair of an Iatrogenic Left Lateral Diaphragmatic Hernia with Intrathoracic Colonic Closed-Loop Obstruction after Remote One Stage Conversion of a Laparoscopic Adjustable Gastric Band (LAGB) to a Laparoscopic Sleeve Gastrectomy (LSG). The patient is a 60-year-old female with a BMI of 30kg/m2 that presented at the emergency department with a 4-day history of abdominal pain and nausea and chest pressure. She had, in an outside facility, a LAGB in 2009, followed by Laparoscopic Repair of a Sliding Hiatal Hernia in 2012 and 10 months prior to this event a Laparoscopic One-Stage Conversion LAGB to LSG. CT Scan of Chest, Abdomen, and Pelvis showed left-sided diaphragmatic defect and a closed-loop incarcerated colonic obstruction, with hypo-attenuation of the colonic incarcerated segment. The video shows the technical details of the laparoscopic exploration, careful strategic dissection and minimal extension of the hernia defect to allow for safe reduction of the incarcerated distended colon and omentum, how to laparoscopically repair the one serosal colonic tear that occurred during the case and the repair of the Iatrogenic Left Lateral Diaphragmatic defect in a position that is likely a result from a missed injury during the prior One Stage laparoscopic Conversion of a LAGB to LSG. The patient had an uneventful recovery.