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. 2025 Jan-Mar;29(1):e2024.00062.
doi: 10.4293/JSLS.2024.00062. Epub 2025 Apr 3.

Primary Roux-en-Y Gastric Bypass with Concurrent Paraesophageal Hernia Repair in Obese Patients

Daniel Knewitz  1 , Jorge Cornejo Aguilar  1 , Shalyn Fullerton  1 , Lorna Evans  1 , Steven Bowers  1 , Enrique Elli  1
Affiliations

Primary Roux-en-Y Gastric Bypass with Concurrent Paraesophageal Hernia Repair in Obese Patients

Daniel Knewitz et al. JSLS. 2025 Jan-Mar.

Abstract

Background and objectives: Additional support for the safety and feasibility of combined paraesophageal hernia repair and Roux-en-Y gastric bypass is needed. We sought to analyze both the short- and long-term outcomes of patients who underwent this combined operation.

Methods: Single institution retrospective analysis of overall morbidity and mortality of patients who underwent primary Roux-en-Y gastric bypass with paraesophageal hernia repair from January 2014 to July 2023.

Results: Fifty-two patients met inclusion criteria. Mean preoperative body mass index was 40 kg/m2. Most patients underwent a robotic approach. Six and three patients were noted to have minor and major postoperative complications, respectively. Ample comorbidity resolution and weight loss outcomes were noted. A robotic approach was associated with a significantly decreased operative time.

Conclusion: Minimally invasive paraesophageal hernia repair with concurrent Roux-en-Y gastric bypass is a feasible and effective procedure, which leads to significant weight loss and associated comorbidity resolution. This simultaneous operation may be accomplished safely and potentially faster via a robotic approach.

Keywords: Gastric bypass; Hiatal hernia; Robotic surgical procedures.

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Conflict of interest statement

Disclosure: The authors have no related conflicts of interest.

Figures

Figure 1.
Figure 1.
Flow diagram.
Figure 2.
Figure 2.
Weight-loss outcomes after combined RYGB and PEH repair.
See this image and copyright information in PMC

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