Endoscopic intraluminal suture plication of the gastric pouch and stoma in postoperative Roux-en-Y gastric bypass patients

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Michael Schweitzer

Abstract

Endoscopic intraluminal suturing is currently used to treat gastroesophageal reflux disease. This new field of intraluminal gastric surgery may benefit postoperative Roux-en-Y gastric bypass patients. While gastric bypass is highly successful in the majority of patients, significant weight regain can occur over time due to stretching of the gastric pouch and stoma. Between November 2002 and January 2003, four patients who previously underwent gastric bypass (GBP) surgery presented with dilated gastrojejunostomy (GJ) anastomosis and weight regain. They gave their consent and were taken to the operating room for upper endoscopy, where they were placed under general anesthesia. Using a flexible endoscopic suturing device with a standard 11-mm endoscope, the dilated GJ anastomosis was plicated to reduce its size, and in two of the patients the gastric pouch was also plicated. Successful stomal plication was performed on all four patients to narrow their dilated stomas that measured > 2 cm preoperatively to < 15 mm postoperatively. Patients were told to go on a puree diet for 4 weeks. One patient had a repeat procedure due to rupture of one suture after eating solid food two weeks after the surgery. The stoma was then plicated with ...Continue Reading

References

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Citations

Oct 12, 2010·JSLS : Journal of the Society of Laparoendoscopic Surgeons·I Michael LeitmanMartin S Karpeh
Sep 10, 2014·Best Practice & Research. Clinical Gastroenterology·E M H Mathus-Vliegen
Sep 4, 2010·Obesity Surgery·Alex Marie Florent HeylenRuediger L Prosst
Jul 26, 2006·Surgical Endoscopy·A MalikB V MacFadyen
Dec 21, 2006·Surgical Endoscopy·C B MorgenthalUNKNOWN SAGES Flexible Endoscopy Committee
May 5, 2007·Surgical Endoscopy·Ke GongKazuki Ueda
Dec 8, 2010·World Journal of Surgery·Gonzalo Torres-VillalobosSayeed Ikramuddin
Apr 28, 2009·Obesity·James C EllsmereLee M Kaplan
Dec 3, 2014·Gastrointestinal Endoscopy·Nathan E Conway, Lee L Swanström
Jun 30, 2009·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Gloria Fernández-EsparrachChristopher C Thompson
Jun 27, 2009·Gastrointestinal Endoscopy·Christopher S Huang

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