Technique for Correction of Stomal Dilatation in the Failed Gastric Exclusion Procedure

Abstract

We describe a new technique for surgically reducing the size of a dilated stoma following the Roux-en-Y gastric bypass operation (RYGB). Of 416 RYGB patients operated on between 1983 and 1986, 6 required correction of a dilated stoma in the absence of pouch distension or staple line dehiscence. Our technique creates a new outlet in the proximal Roux-en-Y jejunum by stapling across the intestinal lumen at the lower border of the gastrojejunostomy anastomosis leaving the original stoma intact. At 1-year follow-up, this procedure prevented weight gain in 4 patients and increased weight loss significantly in 2 patients. We recommend this technique only for those RYGB patients with stomal dilatation who have small pouch reservoirs and intact gastric staple lines.