Six month outcomes in patients experiencing weight gain after gastric bypass who underwent gastrojejunal revision using an endoluminal suturing device

Abstract

Six month follow-up for EGJR patients demonstrated a low-risk, minimally invasive treatment option to reverse weight gain subsequent to a failed gastric bypass. Procedures presented no complications and may provide an attractive alternative to standard surgical revision.

Endoscopic Trans-Oral Outlet Reduction in Combination with Gastroplasty (TORe-G) Is a Novel Technique That Is Highly Efficacious and Safe for Weight Loss in Patients With Failed Roux-en-Y Gastric Bypass (RYGB)

“…No significant difference in weight loss was seen without or without pouch reduction in this cohort; however, these patients did not receive gastroplasty of their entire gastric pouch [15]. A separate group of investigators in a 16 patient study have reported more modest outcomes in patients undergoing endoscopic GJ stoma reduction using the Overstitch device with an average %EWL of 12.4 % at 6 months [14].…”

“…The majority of the weight loss observed in these studies occurred in the first 3-6 months after the procedure [12][13][14][15].…”

“…Although level 1 evidence exists regarding the efficacy of endoscopic trans-oral outlet reduction (TORe), efficacy of gastric pouch revision in terms of weight loss is still unclear. Current evidence suggests an excess weight loss (%EWL) of 12-25% with GJ outlet reduction (TORe) alone [11][12][13][14][15].…”

The use of OverStitchTMfor the treatment of intestinal perforation, fistulas and leaks

“…10 It has been increasingly used to anchor stents within the GI lumen, 11 perform closure of perforations, 11 leaks, and fistulas, in addition to closure of mucosectomy after peroral endoscopic myotomy (POEM), 12,13 Natural Orifice Transluminal Endoscopic Surgery defect closures, 14 and perform primary and revision bariatric procedures. 15,16 This review will focus on endoscopic suturing with the OverStitch TM platform in the management of GI perforations, leaks and fistula.…”

Ensaio clínico randomizado do tratamento endoscópico do reganho de peso pós derivação gástrica em Y de Roux através da moldagem da anastomose gastrojejunal com plasma de argônio isolado versus plasma de argônio associado à sutura endoscópica

“…Estudos posteriores comprovaram a superioridade da sutura de espessura total em relação à espessura parcial, de forma que esta última foi abandonada e seus dispositivos, retirados do mercado 113,114 . Também com o intuito de aprimorar a durabilidade, autores passaram a reportar a associação de métodos de ablação com a sutura endoscópica 115 . A plausibilidade biológica se respalda na observação cirúrgica que a aposição de mucosa com mucosa não gera fusão permanente dos tecidos 116 .…”