Background

Gastropleural fistula is a rare but serious complication of laparoscopic sleeve gastrectomy (LSG) with significant morbidity and mortality. We present a case of a 46 year old female who underwent a robotically assisted laparoscopic LSG. Six months post operatively patient developed dysphagia and a worsening cough. CT abdomen and pelvis was performed which demonstrated a gastropleural fistula with a 5.0 x 4.4 cm left lower lobe abscess. An endoscopy confirmed a gastropleural fistula between the proximal staple line of the sleeve gastrectomy and the left lower lobe. Patient was then taken to the operating room for a left robotic assisted thorascopic lower lobe lobectomy, partial diaphragm resection, primary diaphragm repair and robotic assisted laparoscopic resection of gastropleural fistula. She was ultimately discharged on post-operative day 6 and has since done well and resumed a regular diet.