Ryan M Juza, MD, Vamsi Alli, Ann M Rogers, Eric M Pauli, MD. Penn State Hershey Medical Center
Advanced endoscopic therapies and intraoperative fluoroscopy can be used in a multimodal fashion to effectively manage complications in revisional bariatric surgery. Our video demonstrates the use of a number of such therapies to manage the complex case of a patient with recurrent gastro-gastric fistula following roux en Y gastric bypass. Our patient had undergone gastric bypass surgery 15 years prior. She had previously undergone two traditional laparoscopic revisional bariatric surgeries in an attempt to manage recurrent leaks without success. During her last laparoscopic revision the patient had a positive leak test on an area of the gastric pouch that was inaccessible laparoscopically and would have required converting to an open surgery and a larger resection. Using an endoscopic approach we were able to manage her complications intraluminally and gradually, through repeat interventions, allow the surgical repair to heal. By utilizing a variety of advanced endoscopic therapies we were able to salvage her bariatric procedure and prevent formal surgery re-intervention, prevent the need for parenteral nutrition, and reduce the risk for chronic fistula formation.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87912
Program Number: V181
Presentation Session: Wednesday Video Loop (Non CME)
Presentation Type: VideoLoop
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