{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:55Z","timestamp":1787071375417,"version":"build-2736575974"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A 38-year-old female presented with chronic abdominal pain and nutritional decline due to a gastro-gastric fistula (GGF) following Roux-en-Y gastric bypass. Multiple endoscopic interventions, including OverStitch, fibrin sealant and over-the-scope clip (OTSC) placement, failed to close the fistula. Pre-operative imaging and endoscopy confirmed a patent gastrojejunostomy and an 8-mm GGF with embedded OTSC. A robotic approach was undertaken. Dense adhesions were lysed, and the fistula was dissected and excised. The OTSC was identified and removed intraoperatively. The gastrojejunostomy\u2013fistula complex was resected, and a new hand-sewn gastrojejunostomy was created robotically. The remnant stomach was resected. Endoscopy confirmed an intact anastomosis and a negative leak test. The patient tolerated oral intake on post-operative day one and was discharged on the same day. At 6 months, she remained asymptomatic with stable nutritional status. This case highlights the role of robotic surgery in managing refractory GGF, particularly after failed endoscopic interventions.<\/jats:p>","DOI":"10.4103\/jmas.jmas_252_25","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T18:00:17Z","timestamp":1775584817000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Robotic takedown of gastro-gastric fistula with revision of gastric bypass and reconstruction of gastrojejunostomy"],"prefix":"10.4103","author":[{"given":"Hamdan","family":"Mallick","sequence":"first","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hania","family":"Ahmer","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber","family":"Jacobson","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynnsey","family":"Rebner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Katsichtis","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishnaraj","family":"Mahendraraj","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anirudha","family":"Goparaju","sequence":"additional","affiliation":[{"name":"Department of Surgery, Bayhealth Medical Center, Dover, Delaware, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"R1-20260407","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/j.soard.2005.07.003","article-title":"Management of gastrogastric fistulas after divided Roux-en-Y gastric bypass surgery for morbid obesity: Analysis of 1,292 consecutive patients and review of literature","volume":"1","author":"Carrodeguas","year":"2005","journal-title":"Surg Obes Relat Dis"},{"key":"R2-20260407","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jviscsurg.2019.01.008","article-title":"Robotic reoperation for gastro-gastric fistula after laparoscopic Roux-en-Y gastric bypass (with video)","volume":"156","author":"Reche","year":"2019","journal-title":"J Visc Surg"},{"key":"R3-20260407","doi-asserted-by":"crossref","first-page":"1227","DOI":"10.1016\/j.soard.2015.03.004","article-title":"Surgical management of gastrogastric fistula","volume":"11","author":"Corcelles","year":"2015","journal-title":"Surg Obes Relat Dis"},{"key":"R4-20260407","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.soard.2016.08.005","article-title":"Over-the-scope clip for endoscopic closure of gastrogastric fistulae","volume":"13","author":"Niland","year":"2017","journal-title":"Surg Obes Relat Dis"},{"key":"R5-20260407","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1381\/096089299765553674","article-title":"Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction","volume":"9","author":"Capella","year":"1999","journal-title":"Obes Surg"}],"container-title":["Journal of Minimal Access Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_252_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:45:07Z","timestamp":1787067907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/jmas.jmas_252_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":5,"URL":"https:\/\/doi.org\/10.4103\/jmas.jmas_252_25","relation":{},"ISSN":["0972-9941","1998-3921"],"issn-type":[{"value":"0972-9941","type":"print"},{"value":"1998-3921","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,7]]},"assertion":[{"value":"2025-06-22","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}