Sp805 Endoscopic Remodeling of Gastrojejunostomy after Gastric Bypass

Abstract

Endoscopy has evolved into a major tool in the management of bariatric surgery complications,but has generally been confined to intralumenal therapies, with iatrogenic perforation considered a dreadful complication. Research in NOTES® has led to the development of new endoscopic tools, which have also found meaningful applications in the endoscopic management of surgical complications. The endoscopic suturing system is such an example. A 40-year-old woman underwent a gastric bypass 10 years ago with subsequent successful loss of weight. She now presented with new postprandial epigastric pain, nausea and vomiting. Upper endoscopy identified enlargement of the blind end of the Roux limb, commonly referred to as “candy cane”. It also demonstrated angulation of the efferent side of the Roux limb. This mechanical problem would traditionally require surgical revision of the gastro-jejunostomy with re-connection of the Roux limb to the gastric pouch and resection of the dilated candy cane.