EUS-directed transgastric PEG for long-term enteral feeding in patients with Roux-en-Y gastric bypass anatomy

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 …

Continue reading EUS-directed transgastric PEG for long-term enteral feeding in patients with Roux-en-Y gastric bypass anatomy

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 …

Continue reading 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

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 …

Continue reading Endoscopic blind limb reduction with septotomy: a novel endoscopic approach to candy cane syndrome after Roux-en-Y gastric bypass

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 …

Continue reading Management of a gastric pouch staple-line leak and its adverse events with multimodal endoscopic techniques including endoscopic vacuum therapy

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 …

Continue reading A novel approach for weight regain after Roux-en-Y gastric bypass: Staged transoral outlet reduction (TORe) followed by surgical type 1 distalization

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 …

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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 …

Continue reading Argon plasma coagulation alone vs argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass

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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