Endoscopic gastrostomy after bariatric surgery: a unique approach

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Bariatric Surgery

Background:

• Gastrostomy tube placement can be complex after Roux-en-Y gastric bypass (RYGB).
• Dense abdominal adhesions frequently complicate access to the gastric remnant in RYGB patients.
• There is a need for innovative, minimally invasive techniques for gastrostomy tube placement in RYGB patients.

Observation:

• This study details a novel approach for gastrostomy tube placement.
• The method utilizes a combined endoscopic ultrasound (EUS) and fluoroscopy-guided technique.
• The procedure was performed in a patient with a retrocolic gastric bypass and significant adhesions.

Findings:

• The combined EUS and fluoroscopy-guided approach facilitated successful gastrostomy tube placement.
• This technique offers a viable minimally invasive option for accessing the gastric remnant.
• The essential technical steps of this innovative procedure are described.

Implications:

• This approach may improve outcomes for RYGB patients requiring gastrostomy tubes.
• It offers a less invasive alternative to traditional methods in complex cases.
• Further research could validate this technique in a broader patient population.