Post written by Christina S. Gainey, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA. We present a novel method for placing a PEG tube into the excluded stomach of Roux-en-Y gastric bypass patients, allowing for bolus gastric feeding. Although percutaneous endoscopic jejunostomy tubes are standard …
Tag: Roux-en-Y gastric bypass
Novel approach for weight reduction after Roux-en-Y gastric bypass with weight regain: a combination of Bariatric Anastomotic Reduction System with tubularization of residual gastric pouch
Post written by Rakesh Kalapala, MD, DNB, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. The combination of the Bariatric Anastomotic Reduction System (BARS) with endoscopic sleeve gastroplasty (ESG) of the residual gastric pouch would cause significant anastomotic lumen reduction, with decrease of the size of the residual gastric pouch …
Endoscopic blind limb reduction with septotomy: a novel endoscopic approach to candy cane syndrome after Roux-en-Y gastric bypass
Post written by Kambiz Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe a new endoscopic procedure to treat candy cane syndrome in Roux-en-Y gastric bypass patients. The syndrome refers to patients who have undergone Roux-en-Y gastric bypass and developed significant and sometimes debilitating postprandial abdominal discomfort that is often relieved …
Management of a gastric pouch staple-line leak and its adverse events with multimodal endoscopic techniques including endoscopic vacuum therapy
Post written by Khanh Hoang Nicholas Le, MD, MS, from the University of California San Diego Medical Center, San Diego, California, USA. This video describes a 48-year-old woman with history of a mini-gastric bypass converted to a Roux-en-Y gastric bypass who was found to have a gastric pouch staple-line (GPSL) leak, later complicated by a gastrogastric …
A novel approach for weight regain after Roux-en-Y gastric bypass: Staged transoral outlet reduction (TORe) followed by surgical type 1 distalization
Post written by Omar M. Ghanem, MD, from the Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA. The video describes a case of a patient suffering from weight regain after open Roux-en-Y gastric bypass (RYGB) in 2003. The patient’s presenting BMI was 59. We elected to perform a novel staged endo-laparoscopic approach with transoral outlet …
Switching the switch: endoscopic reversal of a biliopancreatic diversion
Post written by Manol Jovani, MD, MPH, from the Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland. Biliopancreatic diversion (also known as duodenal switch) is a complex bariatric surgery that includes a sleeve gastrectomy and long Roux-en-Y intestinal bypass. This is a very effective surgery for weight loss, but it can be complicated …
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Use of a rigidizing overtube for altered-anatomy ERCP
Post written by Mike Tzuhen Wei, MD, from Stanford University, Stanford, and Veterans Affairs Palo Alto, Palo Alto, California. We present 2 cases in which the rigidizing overtube was used to facilitate performance of altered-anatomy ERCP. In the first case, a 53-year-old woman with history of Roux-en-Y hepaticojejunostomy presented for management of intrahepatic stones. Interventional …
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Permanent endoscopic reversal of Roux-en-Y gastric bypass for diagnosis and long-term palliation of pancreatic cancer
Post written by Seifeldin Hakim, MD, and Phillip S. Ge, MD, from the Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Patients with Roux-en-Y gastric bypass (RYGB) anatomy face unique technical challenges in the management of pancreaticobiliary malignancy. EUS-guided RYGB reversal (known as EDGE or GATE …
Argon plasma coagulation alone vs argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass
Post written by Vitor Ottoboni Brunaldi, MD, MSc, from the Gastrointestinal Endoscopy Unit, Gastroenterology Department, University of São Paulo Medical School, São Paulo, Brazil, and the Center for Gastrointestinal Endoscopy, Surgery and Anatomy Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil. We aimed to compare APC alone to APC plus endoscopic …
Comparing EUS-GG-ERCP and e-ERCP in patients with RYGB
Post written by Majidah Bukhari, MBBS, MD, FRCPC, from the Department of Medicine and Division of Gastroenterology and Hepatology, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA, and King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia. Roux-en-Y gastric bypass (RYGB) remains one of the most commonly performed bariatric surgeries worldwide. ERCP in patients with …
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