Abstract
idesu Roux-en-Y gastric bypass (RYGB) has been advocated for the treatment of gastroesophageal reflux in obese and nonobese patients [1,2]. Its effect in the resolution of reflux symptoms has been shown to be independent of weight loss [3,4]. The mechanism of its action in controlling reflux is reducing parietal cells in the stomach pouch as well as diverting bile via the jejuno–jejunal anastomoses. Unfortunately, this mechanism does not address the role of a weak lower esophageal sphincter (LES) and transient LES relaxation (TLESR) as contributing factors in reflux symptoms [5,6]. Managing patients who present with reflux after RYGB can be challenging. Revision of the gastric pouch has been described along with other procedures to treat this problem. We present a case of laparoscopic augmentation of the LES using the LINX system (Torax Medical, Inc., Shoreview, Minnesota) and repair of hiatal hernia to control reflux after RYGB.
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