Related Experiment Video
Updated: Jul 10, 2026
A Protocol for Roux-en-Y Gastric Bypass in Rats using Linear Staplers
Published on: August 21, 2021
Laparoscopic gastric bypass with intestinal malrotation
Aaron W James1, Rasa Zarnegar, Hisae Aoki
1Department of Surgery, University of California San Francisco, San Francisco, CA 94143-0790,, USA.
Insights
Intestinal malrotation, a congenital condition, can be unexpectedly found during adult laparoscopic Roux-en-Y gastric bypass (LRYGBP). This finding does not prevent the bariatric surgery from being safely completed.
Area of Science:
- Gastroenterology and Surgical Procedures
- Congenital Anomalies
- Bariatric Surgery
Background:
- Intestinal malrotation is a congenital anomaly affecting approximately 1 in 500 live births.
- While typically diagnosed in infancy, it can remain asymptomatic and undetected until adulthood.
- Adult presentation often occurs incidentally during radiographic or surgical interventions.
Observation:
- This report details a case where intestinal malrotation was identified during a laparoscopic Roux-en-Y gastric bypass (LRYGBP).
- The case highlights the technical considerations required to successfully complete the LRYGBP in the presence of this anomaly.
- A review of existing literature on this rare clinical scenario is also provided.
Findings:
- Incomplete intestinal malrotation was discovered intraoperatively during a LRYGBP procedure.
- The surgical team successfully adapted techniques to manage the malrotation and complete the bariatric surgery.
- Literature review confirms the rarity of this presentation in adult bariatric surgery patients.
Implications:
- The presence of incomplete intestinal malrotation should not be considered an absolute contraindication for performing LRYGBP in patients with morbid obesity.
- Surgeons should be prepared to manage incidental findings of intestinal malrotation during LRYGBP.
- This case contributes to the understanding of managing congenital anomalies in the context of advanced bariatric procedures.
Abstract:
Intestinal malrotation is a congenital anomaly occurring in one of 500 live births. It typically presents during the first months of life, but in rare instances, it can persist undetected into adulthood when it is identified during a radiographic or surgical procedure. We present a case of intestinal malrotation discovered at the time of laparoscopic Roux-en-Y gastric bypass (LRYGBP), detail the technical aspects needed to be incorporated to complete the operation, followed by a literature review of this rare clinical scenario. Incomplete malrotation is not a contraindication to performing a LRYGBP for morbid obesity.
