In the short-term, LSG is a safe and effective treatment option.

Laparoscopic bariatric surgery can be performed relatively safely in morbidly obese patients who are treated with chronic oral anticoagulation. Even in the presence of bleeding, patients can be successfully treated without the need for reoperation.

Gastric electrical stimulator may improve gastrointestinal symptoms, reduce the use of drug therapy, and offer subsequent improvement in patients' general life satisfaction. This procedure is relatively safe for patients with refractory gastroparesis. Further studies are required to confirm these results.

Recurrent obstructive symptoms after cardiomyotomy for achalasia occur in approximately 10 per cent to 15 per cent of patients, but only some require reoperation. Reoperative procedures for achalasia vary, and in general, have less success in relieving symptoms than the initial procedure. We present the case of a 37-year-old male with a 15-year history of recurrent achalasia, with symptoms of heartburn and progressive dysphagia after meals. He underwent several esophageal dilatations, botox injections, and two transthoracic Heller myotomies before the transabdominal esophagogastro-Roux-en-Y jejunostomy was performed. This case represents another surgical option for management of the challenging problem of recurrent achalasia.