ArticleJournal of surgical case reports2026
Robotic Heineke-Mikulicz stricturoplasty for refractory incisura angularis stenosis after sleeve gastrectomy: an anatomy-preserving case report.
Article in Journal of surgical case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Gastric sleeve stenosis is an uncommon yet serious complication following sleeve gastrectomy (SG). Initial management typically involves endoscopic balloon dilation; however, refractory cases may require revisional surgery, often conversion to a Roux-en-Y gastric bypass (RYGB). We present the case of a 44-year-old woman with a symptomatic stenosis at the incisura angularis, 1 month after SG, refractory to three endoscopic balloon dilations. Given the localized nature of the stenosis and the patient's preference to avoid bypass, she underwent robotic Heineke-Mikulicz stricturoplasty. The patient had an uncomplicated postoperative course and remained asymptomatic at follow-up. This case highlights the feasibility and advantages of stricturoplasty as an organ-preserving alternative to gastric bypass in selected patients with localized refractory sleeve stenosis, preserving gastrointestinal continuity and possibly reducing long-term nutritional considerations associated with bypass procedures. Further studies with longer follow-up are needed to better define patient selection, durability, and comparative outcomes with conversion to RYGB.
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