Technical Considerations In Performing One Anastomosis Gastric Bypass In Case of Intestinal Malrotation

Abstract

Intestinal malrotation is a rare congenital anomaly that originates from the failure of the normal rotation and fixation of the midgut during embryologic development. There are different types of Midgut Malrotation which includes non-rotation, incomplete rotation, reverse rotation, or anomalous fixation of the mesentery. Methods: We present a case of a 58-year-old woman with a BMI of 45.3 kg/m2. The patient underwent laparoscopic appendectomy 15 years ago and was diagnosed with a partial situs inversus. She has no other past medical conditions. Results: At the operation, four meters of small bowel were counted backward from the ileocaecal valve until the duodenum. We performed a one anastomosis gastric bypass with three meters of common limb and one meter of biliopancreatic limb, gastro-intestinal anastomosis made with a linear stapler, and the defect sutured with absorbable suture. Conclusion: One anastomosis gastric bypass is a feasible and safe alternative for morbidly obese patients with intestinal malrotation or multiple intestinal adhesions.