Low-cost modified endoscopic vacuum therapy using a triple-lumen tube allows nutrition and drainage for treatment of an early post-bariatric surgery leak.

Abstract

Leaks after laparoscopic sleeve gastrectomy (LSG) occur in up to 5 % of patients, with mortality rates approaching 4 % [1]. Among available therapies for leaks after bariatric surgery, endoscopic approaches have been shown to be safe and effective. Tissue sealants, cap-mounted clips, suturing, stents, a cardiac septal defect occluder, septotomy, endoscopic internal drainage with double pigtails, and endoscopic vacuum therapy (EVT) are the forefront of the therapeutic endoscopic arsenal [2] [3]. However, an individualized approach is needed to determine the best endoscopic treatment strategy for a given patient. In this video, we describe the successful treatment of a LSG leak using low-cost modified EVT.