Incidental oesophageal leiomyoma during laparoscopic Roux-en-Y gastric bypass: finding the unexpected does not affect outcomes

Most bariatric procedures are now performed laparoscopically. Here, we describe a case of incidental oesophageal leiomyoma found during laparoscopic Roux-en-Y gastric bypass (LRYGB). To our knowledge, this is the first such case reported. Our patient was admitted for an elective LRYGB. She had no upper gastrointestinal symptoms, and therefore did not undergo preoperative oesophagogastroduodenoscopy (OGD). During surgery, a hiatus hernia and an incidental oesophageal leiomyoma were found and treated with hernia repair and enucleation. The end outcome was unaffected. We were able to concomitantly treat the unexpected finding of an oesophageal leiomyoma and a hiatus hernia during the LRYGB. The routine use of OGD prior to bariatric surgery is still controversial. While surgeons should be prepared for unexpected pathologies, when performing laparoscopic bariatric surgery, a routine OGD prior to LRYGB is probably not necessary in asymptomatic patients. Laparoscopic enucleation of oesophageal leiomyoma during LRYGB is feasible and safe.