Endoscopic treatment of weight regain after Roux-en-Y gastric bypass (RYGB): use of argon plasma coagulation (APC) in the gastro-jejunal anastomosis.

Jh Felicio De Lima, PhD, Prof, Gap Baretta, PhD, Jm Campos, PHD, M Galvao Neto, MD. ENDOBATEL – Advanced Digestive Endoscopic Center – Hospital Vita Batel in Curittiba – Brazil.

The normal anatomy after RYGB promotes food restriction related to the size of the pouch and the diameter of the gastro-jejunal anastomosis.

The loss of satiety and food restriction occurs after dilation of the anastomosis.
Diameters larger than 15 mm allow rapid passage of food.

The sequential application of argon plasma at the anastomosis was performed every 8 weeks. 3 sessions were used in total.

The argon plasma coagulation was taken across the anastomotic circumference.

The objective was to induce a burn and subsequent healing in an attempt to reduce the diameter of the gastro-jejunal anastomosis which was 25 mm.

We observed a reduction to 15 mm after the first session. So did the second session.

After 8 weeks, we detected an anastomosis of 10 mm and new complementary session was made.

The final control showed an anastomotic diameter of 7 mm.

The new food restriction and satiety allowed an average loss of 90% of weight regain.

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