Abstract
Introduction
Gastropleural fistulas (GPF) were first described by Markowitz and Herter in 1960. These are uncommon entities and can occur as a consequence of pulmonary surgery, trauma, malignancy, hiatal hernia, infections, Nissen fundoplication and most recently, bariatric surgery. Many treatments have been used for GPF, such as conservative management with antibiotics, parenteral nutrition, percutaneous drainage of collections and endoscopic therapies, but these usually fail and may lead to complex surgical procedures.
Case description/operative technique
Two patients diagnosed with GPF after bariatric surgeries were treated in our program. After failure of conservative management, both were subjected to laparoscopic-robotic assisted gastropleural fistula resection. Case 1 was a patient who had a sleeve gastrectomy 1 year prior, required partial esophagogastrectomy and esophagojejunal anastomosis. Case 2 had an open gastric bypass 13 years prior, and when medical resolution of fistula was not possible, he underwent a partial remnant gastrectomy and hiatal hernia repair.
Discussion
Appearance of gastroplueral fistula after bariatric surgery is a rare occurrence. When surgical management is needed, we have noticed that the use of the robotic platform in these complex surgical cases is safe and feasible.
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Conflict of interest
Drs. Pedro Garcia-Quintero Pedro, Christian Hernandez-Murcia, Rey Romero, and John Derosimo declare that they have no conflict of interest. Dr. Anthony Gonzalez has received speaker honorarium from Intuitive Surgical, Cadence Pharmaceuticals and Ethicon. He has also received research Grants and participated in the scientific advisory board for Minimally Invasive Devices, Inc.
Ethical standards
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000 (5).
Consent section
Written informed consent was obtained from the patient for publication of this Case Report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
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Garcia-Quintero, P., Hernandez-Murcia, C., Romero, R. et al. Gastropleural fistula after bariatric surgery: a report of two cases. J Robotic Surg 9, 163–166 (2015). https://doi.org/10.1007/s11701-015-0505-4
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DOI: https://doi.org/10.1007/s11701-015-0505-4