Robotic gastric conduit revision after previous Ivor-lewis esophagectomy

S. Fortich¹, J. Lentz Carvalho¹, R. Petrov^2
1The University of Texas Medical Branch, Galveston, Texas ²University of Texas Medical Branch, Galveston, Texas

Please explain the educational or technical point that this video addresses.: Robotic gastric conduit mobilization from extensive intrathoracic adhesions.
Robotic gastric conduit revision.
Robotic Hiatal closure
Robotic Pyloroplasty

Please provide a 250 word summary of the surgical video being submitted.: The case is about a 32-year-old male that had a PMH of membranous pemphigoid with esophageal strictures that failed endoscopic dilations. The patient had progressive dysphagia being dependent of J tube feedings and TPN.
Was admitted to our facility due to abdominal pain and J-tube leakage with skin breakdown. During CT chest, it was noted that the gastric conduit was dilated up to 7 cm with food inside of it. Subsequently, an EGD was performed with botox injection. The patient's dysphagia did not improve, so the decision was to perform a gastric conduit revision.
The surgery was extremely difficult due to extensive intrathoracic and intraabdominal adhesions. Despite this, the team was able to perform and complete gastric conduit revision, a hiatal repair, a pyloroplasty, and an EC fistula takedown without the need for an open technique. The patient tolerated the procedure well and was able to tolerate a full liquid diet during his postoperative course.