Millions of patients find it extremely difficult to achieve durable weight loss without medical intervention. Many opt for bariatric surgery to achieve a healthier weight, but up to 30% of patients who undergo these procedures regain weight. There are a variety of reasons for regaining weight after bariatric surgery. In some cases, there may be dysfunction of the stomach pouch that was surgically created. Others may experience dangerous and painful complications, such as fistulas and leaks. Patients who experience these types of post-bariatric surgical problems are reluctant to undergo another invasive procedure to correct the issues.
Alternatives to Bariatric Surgery Complications
In recent years, an important treatment alternative has emerged for this patient population thanks to advanced endoscopy. Using this approach, we can address post-bariatric surgery problems like fistulas, ulcers, and lap band erosion with less invasive endoscopic surgery techniques. Advanced endoscopy enables clinicians to:
Locate and repair defects.
Close leaks and fistulas with endoscopic sutures.
Reduce patient discomfort.
Reduce postoperative recovery time.
Help re-establish proper pouch dimensions.
Help stop weight gain and aid in weight loss.
With advanced endoscopy, we’re able to perform endoscopic pouch reduction surgery to restore the stomach pouch to its original post-surgery dimensions and halt weight gain. These procedures help patients experience less postoperative discomfort, as there is minimal to no blood loss, no external cuts, and no need to re-route the existing anatomy. This results in shorter hospital recovery times, with most patients going home the same day.
Advanced endoscopic techniques can be beneficial to manage complications after bariatric surgery. These include repairing and/or addressing gastric pouch dysfunction/defects, esophageal and gastric fistulas, sleeve leaks, eroded lap bands, mucosal ulceration, and stent migration.
Endoscopy Optimizes Bariatric Surgery Outcomes
As the nation struggles to address obesity and the profound impact it can have on individual health, bariatric surgery is a valuable option. Surgeons need to be vigilant in situations when postoperative complications occur after bariatric surgery. Endoscopic procedures can effectively treat post-bariatric surgery complications and weight gain and can be an excellent option for patients and their physicians who wish to address these issues without undergoing further invasive surgery.
Referring patients to interventional endoscopic specialists who can manage these complications swiftly and with as little harm as possible can enable patients to reap all the benefits that are associated with these surgeries. With reduced recovery time and minimal discomfort, corrective endoscopic procedures can help patients reclaim the benefits of the original bariatric procedure.
Readings & Resources (click to view)
For more information on advanced and interventional endoscopic procedures available at New Jersey Advanced Gastroenterology, go to BariatricRepair.com.
Sullivan S. Endoscopy in the management of obesity. Gastrointest Endosc Clin N Am. 2013;23:165-175.
Singhal S, Le DL, Duddempudi S, Anand S. The role of endoscopy in bariatrics: past, present, and future. J Laparoendosc Adv Surg Tech A. 2012;22:802-811.
Stimac D, Majanović SK. Endoscopic approaches to obesity. Dig Dis. 2012;30:187-195.
Gill RS, Whitlock KA, Mohamed R, Sarkhosh K, Birch DW, Karmali S. The role of upper gastrointestinal endoscopy in treating postoperative complications in bariatric surgery. J Interv Gastroenterol. 2012;2:37-41.