Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Apr-Jun;14(2):217-20.
doi: 10.4293/108680810X12785289144241.

Early results of trans-oral endoscopic plication and revision of the gastric pouch and stoma following Roux-en-Y gastric bypass surgery

I Michael Leitman  1 , Chiranjiv S Virk, Dimitrios V Avgerinos, Radha Patel, Valentina Lavarias, Burton Surick, John L Holup, Elliot R Goodman, Martin S Karpeh Jr
Affiliations

Early results of trans-oral endoscopic plication and revision of the gastric pouch and stoma following Roux-en-Y gastric bypass surgery

I Michael Leitman et al. JSLS. 2010 Apr-Jun.

Abstract

Objective: A new technique for endoscopic plication and revision of the gastric pouch (EPRGP) for patients who underwent gastric bypass (RGB) surgery was evaluated in patients with severe GERD, dumping syndrome, failure of weight loss, or all of these.

Patients and methods: Patients underwent EPRGP over a 12-month period. The StomaphyX device (Endogastric Solutions, Redmond, WA) was utilized over a standard flexible gastroscope. Patients were kept on a liquid diet for 1 week.

Results: The study included 64 patients with a mean age of 48 years who underwent 67 procedures. EPRGP was performed an average of 5 years after RGB. The mean preoperative BMI was 39.5 kg/m². The primary indications for the procedure were inadequate weight loss, dumping syndrome (42), and GERD (15). The mean follow-up period was 5.8 months (range, 3 to 12). The average operative time was 50 minutes, with a significant reduction with increased operator experience. There were only 2 (3%) intraoperative complications during the early period (equipment failure), which did not result in any morbidity. All symptoms from dumping syndrome or reflux improved, with no further operative-related complications. The mean weight loss was 7.3 kg.

Conclusions: This study demonstrates the technical feasibility, safety, and efficacy of EPRGP.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Preoperative endoscopic photograph of the gastrojejunostomy.
Figure 2.
Figure 2.
Endoscopic photograph of gastrojejunostomy following endoscopic revision.
Figure 3.
Figure 3.
Endoscopic photograph of the gastroesophageal junction and endoscopically reduced gastric pouch.
See this image and copyright information in PMC

References

    1. Campos GM, Rabl C, Mulligan K, et al. Factors associated with weight loss after gastric bypass. Arch Surg. 2008. September;143(9):877–883 - PMC - PubMed
    1. Carrodeguas L, Szomstein S, Soto F, et al. Management of gastrogastric fistulas after divided Roux-en-Y gastric bypass surgery for morbid obesity: analysis of 1,292 consecutive patients and review of literature. Surg Obes Relat Dis. 2005;1(5):467–474 - PubMed
    1. Shah M, Simha V, Garg A. Review: long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. J Clin Endocrinol Metab. 2006;91(11):4223–4231 - PubMed
    1. Gagner M, Gentileschi P, de Csepel J, et al. Laparoscopic Reoperative Bariatric Surgery: Experience from 27 consecutive patients. Obes Surg. 2002;12(2):254–260 - PubMed
    1. Hallowell PT, Stellato TA, Yao DA, Robinson A, Schuster MM, Graf KN. Should bariatric revisional surgery be avoided secondary to increased morbidity and mortality? Am J Surg. 2009;197(3):391–396 - PubMed

LinkOut - more resources