A rare presentation of gastric outlet obstruction following a robotic-assisted Nissen fundoplication: a case report

Background: There has been wide adoption of robotically assisted anti-reflux operation amongst thoracic surgeons in the last decade. Improved ergonomics, dexterity and visualization have overcome the limitations of laparoscopy, but the outcome differences remain widely debated. Currently, there is limited data to suggest robotic assisted anti-reflux operations reduce post-operative morbidity in comparison to laparoscopic approach. Transmediastinal wrap migration, slippage, crural and wrap disruption are known short and long-term complications following anti-reflux operations. There are few reports that discuss gastric volvulus as a long-term failure finding after robotic-assisted anti-reflux operations. We highlight a rare presentation of acute gastric volvulus 6 months after robotic assisted Nissen fundoplication.