Obstruction after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a known complication. We present a video of a patient who suffered both early Roux limb obstruction, and late Petersen's hernia with proximal biliopancreatic limb volvulus and gangrene up to the ligament of Treitz, and how both were managed.
Keywords: Brolin's anti-obstruction stitch; Gastric bypass; Internal hernia; Obstruction; Small bowel resection; Volvulus.