# Revisional surgery for persistent dysphagia plus Roux Y gastric bypass robot-assisted in a patient with obesity. About a case

## TL;DR

A patient with persistent dysphagia and obesity underwent successful robotic revisional surgery to address scar tissue and fibrosis from a previous procedure.

## Contribution

Demonstrates the effectiveness of robotic surgery in resolving postsurgical adhesions causing dysphagia in obese patients.

## Key findings

- The patient experienced significant postoperative symptom improvement after robotic revisional surgery.
- Postsurgical adhesions were identified as the cause of persistent dysphagia and required surgical intervention.
- Robotic-assisted Roux Y gastric bypass was successfully performed without complications.

## Abstract

This case study presents a female patient with progressive dysphagia for solids, heartburn, and obesity that proved refractory to clinical management. Imagenological diagnosis revealed esophageal stenosis and achalasia. Furthermore, metabolic syndrome was established. We proposed intervention through esophagogastric reconstruction due to stenosis, revision of cardiomyotomy and robotic gastric bypass revealing scar tissue and fibrosis on the anterior aspect of the stomach resulting from prior fundoplication surgery. The patient underwent esophagogastric reconstruction due to adhesion bands which conditioned partial angulation of the gastroesophageal junction, cardiomyotomy revision, anterior and posterior hiatal plasty, and Roux Y Gastric Bypass assisted by a robot without complications. The intervention resulted in significant improvement in postoperative symptoms. This case highlights the importance of considering the probability of mechanical obstruction due to postsurgical adhesions in the initial evaluation of recurrent and persistent dysphagia, with surgical reintervention being the ideal option for resolution.