Multiple concurrent complications of Roux-en-Y gastric bypass with MiniMizer gastric ring—alimentary limb intussusception through slipped ring into pouch, with remnant stomach internal herniation†

Roux-en-Y gastric bypass (RYGB) is the second most common bariatric procedure performed in Australia, second to sleeve gastrectomy. Banding of pouches and anastomoses, via silastic bands or MiniMizer rings, have been used to assist in improving restriction. Though banded gastric bypasses are effective in weight loss, band migration, whether it be slippage or erosion, occurs in up to 7% of banded bariatric procedures. Jejunal intussusception and internal herniation are both individually known complications of RYGB. It is, however, rare to have all three phenomenon occur in a single patient. In this study, the authors present a report of a middle-aged lady, 2 years post-primary RYGB with MiniMizer gastric ring insertion presenting with all three complications.