Digestive Disease Interventions
DOI: 10.1055/s-0044-1789187
Review Article

The Evolving Role of Endoscopy in Revisional Metabolic and Bariatric Surgery

Richard R. Rieske
1   Vanderbilt University Medical Center, Nashville, Tennessee
,
Jessica Ardila-Gatas
1   Vanderbilt University Medical Center, Nashville, Tennessee
› Author Affiliations

Abstract

The obesity epidemic continues to be a global health concern impacting over 890 million adults worldwide. These numbers have quadrupled since 1990, and global health surveys estimate another 2.5 billion adults are overweight. The disease of obesity is chronic in nature and difficult to treat. The number of metabolic and bariatric surgeries performed today continues to increase and with it the number of revisional surgeries and management of complications. Upper gastrointestinal endoscopy has played an important role in diagnosing and managing patients with obesity. Endoscopy is a safe and minimally invasive technique to address surgical complications and explore new techniques for the management of obesity. In this article, we aim to review the evolving role of endoscopy in revisional bariatric surgery: management of immediate complications, including bleeding, strictures, leaks, and erosion of bands; techniques to access the gastric remnant after a gastric bypass; and management of weight regain.



Publication History

Received: 01 July 2024

Accepted: 23 July 2024

Article published online:
14 August 2024

© 2024. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 
  • References

  • 1 Phelps NH, Singleton RK, Zhou B. et al; NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. Lancet 2024; 403 (10431): 1027-1050
  • 2 Clapp B, Ponce J, Corbett J. et al. American Society for Metabolic and Bariatric Surgery 2022 estimate of metabolic and bariatric procedures performed in the United States. Surg Obes Relat Dis 2024; 20 (05) 425-431
  • 3 Jessica A-G, Wayne E. Endoscopic management of early complications following bariatric surgery. Mini Invasive Surg 2022; 6: 21
  • 4 Sharma G, Ardila-Gatas J, Boules M. et al. Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass. Surgery 2016; 160 (04) 885-891
  • 5 Suter M, Calmes JM, Paroz A, Giusti V. A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates. Obes Surg 2006; 16 (07) 829-835
  • 6 Spann MD, Aher CV, English WJ, Williams DB. Endoscopic management of erosion after banded bariatric procedures. Surg Obes Relat Dis 2017; 13 (11) 1875-1879
  • 7 Rogalski P, Swidnicka-Siergiejko A, Wasielica-Berger J. et al. Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis. Surg Endosc 2021; 35 (03) 1067-1087
  • 8 De Palma GD, Forestieri P. Role of endoscopy in the bariatric surgery of patients. World J Gastroenterol 2014; 20 (24) 7777-7784
  • 9 Bonanomi G, Prince JM, McSteen F, Schauer PR, Hamad GG. Sealing effect of fibrin glue on the healing of gastrointestinal anastomoses: implications for the endoscopic treatment of leaks. Surg Endosc 2004; 18 (11) 1620
  • 10 Martínez Hernández A, Beltrán Herrera H, Martínez García V. et al. Stent management of leaks after bariatric surgery: a systematic review and meta-analysis. Obes Surg 2022; 32 (04) 1034-1048
  • 11 Ayathamattam J, Ahmed S, Richard N. Endoscopic management of bariatric complications. Surgery (Oxf) 2022; 40 (09) 614-618
  • 12 Espinel J, Pinedo E. Stenosis in gastric bypass: endoscopic management. World J Gastrointest Endosc 2012; 4 (07) 290-295
  • 13 Mansoor MS, Tejada J, Parsa NA, Yoon E, Hida S. Off label use of lumen-apposing metal stent for persistent gastro-jejunal anastomotic stricture. World J Gastrointest Endosc 2018; 10 (06) 117-120
  • 14 Mala T. The gastric remnant in Roux-en-Y gastric bypass: challenges and possibilities. J Clin Gastroenterol 2016; 50 (07) 527-531
  • 15 Bertin PM, Singh K, Arregui ME. Laparoscopic transgastric endoscopic retrograde cholangiopancreatography (ERCP) after gastric bypass: case series and a description of technique. Surg Endosc 2011; 25 (08) 2592-2596
  • 16 Walsh C, Karmali S. Endoscopic management of bariatric complications: a review and update. World J Gastrointest Endosc 2015; 7 (05) 518-523
  • 17 Baron TH, Song LM, Ferreira LE, Smyrk TC. Novel approach to therapeutic ERCP after long-limb Roux-en-Y gastric bypass surgery using transgastric self-expandable metal stents: experimental outcomes and first human case study (with videos). Gastrointest Endosc 2012; 75 (06) 1258-1263
  • 18 Kedia P, Shah-Khan S, Tyberg A. et al. Endoscopic ultrasound-directed transgastric ERCP (EDGE): a multicenter US study on long-term follow-up and fistula closure. Endosc Int Open 2023; 11 (05) E529-E537
  • 19 Tagaya N, Kasama K, Inamine S. et al. Evaluation of the excluded stomach by double-balloon endoscopy after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2007; 17 (09) 1165-1170
  • 20 Kashani A, Abboud G, Lo SK, Jamil LH. Double balloon enteroscopy-assisted endoscopic retrograde cholangiopancreatography in Roux-en-Y gastric bypass anatomy: expert vs. novice experience. Endosc Int Open 2018; 6 (07) E885-E891
  • 21 Bulajic M, Vadalà di Prampero SF, Boškoski I, Costamagna G. Endoscopic therapy of weight regain after bariatric surgery. World J Gastrointest Surg 2021; 13 (12) 1584-1596
  • 22 Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol 2011; 9 (03) 228-233
  • 23 Kumar N, Thompson CC. Transoral outlet reduction for weight regain after gastric bypass: long-term follow-up. Gastrointest Endosc 2016; 83 (04) 776-779
  • 24 Hakiza L, Sartoretto A, Burgmann K. et al. Transoral Outlet Reduction (TORe) for the treatment of weight regain and dumping syndrome after Roux-en-Y gastric bypass. Medicina (Kaunas) 2023; 59 (01) 125
  • 25 Vargas EJ, Abu Dayyeh BK, Storm AC. et al. Endoscopic management of dumping syndrome after Roux-en-Y gastric bypass: a large international series and proposed management strategy. Gastrointest Endosc 2020; 92 (01) 91-96
  • 26 Vargas EJ, Bazerbachi F, Rizk M. et al. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc 2018; 32 (01) 252-259
  • 27 Jirapinyo P, Kumar N, AlSamman MA, Thompson CC. Five-year outcomes of transoral outlet reduction for the treatment of weight regain after Roux-en-Y gastric bypass. Gastrointest Endosc 2020; 91 (05) 1067-1073
  • 28 Petchers A, Walker A, Bertram C, Feustel P, Singh TP, Zaman J. Evaluation of endoscopic gastrojejunostomy revision after Roux-en-Y gastric bypass for treatment of dumping syndrome. Gastrointest Endosc 2022; 96 (04) 639-644
  • 29 Jirapinyo P, Kröner PT, Thompson CC. Purse-string transoral outlet reduction (TORe) is effective at inducing weight loss and improvement in metabolic comorbidities after Roux-en-Y gastric bypass. Endoscopy 2018; 50 (04) 371-377
  • 30 Mullady DK, Lautz DB, Thompson CC. Treatment of weight regain after gastric bypass surgery when using a new endoscopic platform: initial experience and early outcomes (with video). Gastrointest Endosc 2009; 70 (03) 440-444
  • 31 Thompson CC, Jacobsen GR, Schroder GL, Horgan S. Stoma size critical to 12-month outcomes in endoscopic suturing for gastric bypass repair. Surg Obes Relat Dis 2012; 8 (03) 282-287
  • 32 Gallo AS, DuCoin CG, Berducci MA. et al. Endoscopic revision of gastric bypass: Holy Grail or Epic fail?. Surg Endosc 2016; 30 (09) 3922-3927
  • 33 Himpens J, Dobbeleir J, Peeters G. Long-term results of laparoscopic sleeve gastrectomy for obesity. Ann Surg 2010; 252 (02) 319-324
  • 34 Eid G. Sleeve gastrectomy revision by endoluminal sleeve plication gastroplasty: a small pilot case series. Surg Endosc 2017; 31 (10) 4252-4255
  • 35 Maselli DB, Alqahtani AR, Abu Dayyeh BK. et al. Revisional endoscopic sleeve gastroplasty of laparoscopic sleeve gastrectomy: an international, multicenter study. Gastrointest Endosc 2021; 93 (01) 122-130
  • 36 Sharaiha RZ, Kedia P, Kumta N, Aronne LJ, Kahaleh M. Endoscopic sleeve plication for revision of sleeve gastrectomy. Gastrointest Endosc 2015; 81 (04) 1004
  • 37 Jirapinyo P, de Moura DTH, Thompson CC. Sleeve in sleeve: endoscopic revision for weight regain after sleeve gastrectomy. VideoGIE 2019; 4 (10) 454-457
  • 38 D'Alessandro A, Dumont JL, Dagher I. et al. Endoscopy management of sleeve gastrectomy stenosis: what we learned from 202 consecutive patients. Surg Obes Relat Dis 2023; 19 (03) 231-237