VideoGIE
Novel technique for the management of staple line leaks after sleeve gastrectomy
Laparoscopic vertical sleeve gastrectomy (SG) is now the most common bariatric surgical procedure performed in the United States. Staple line leaks occur in 1% to 7% of these patients. Endoscopic and percutaneous management is preferred because there is a significant morbidity associated with surgical reintervention.Endoscopic reversal of gastric bypass for severe malnutrition after Roux-en-Y gastric bypass surgery
Severe malnutrition has been reported in 4% of patients after Roux-en-Y gastric bypass surgery. This condition leads to hospitalization in 54% of patients, with a mortality rate of 18%. The common causes of severe malnutrition after bariatric surgery include surgical mechanical adverse events and noncompliance with nutritional supplements. The treatment involves nutritional support and correction of the underlying causes; surgical reversal is required in some cases. In this video, we demonstrate endoscopic fistulization and stent bridge of the functional and defunctionalized stomach as a therapeutic option for severe malnutrition after Roux-en-Y gastric bypass surgery.Closure of a large, persistent enterocutaneous fistula by use of a ventricular septal occluder
Enterocutaneous fistulas are associated with a significant morbidity and a mortality of between 5% and 20%. The most common causes are iatrogenic (jejunal feeding), Crohn’s disease, radiotherapy-induced, and secondary to malignancy. These patients are often poor surgical candidates, and hence a minimally invasive technique for closure may offer significant benefits.Closure of a chronic tracheoesophageal fistula by use of a cardiac septal occluder
In adults, an acquired tracheoesophageal fistula (TEF) is most commonly the result of cuff-induced tissue necrosis from prolonged mechanical ventilation. These patients are often poor surgical candidates, and hence a minimally invasive technique for closure may offer significant benefits.
