Choosing the best endoscopic approach for post-bariatric surgical leaks and fistulas: Basic principles and recommendations

Figure 8 Cardiac septal defect occluder for the treatment of chronic fistulas after bariatric and metabolic surgery. A: Endoscopic imaging of a successful closure of a gastrocutaneous fistula after cardiac septal defect occluder (CSDO) placement in a distal staple line leak after laparoscopic sleeve gastrectomy; B: Methylene blue test showing no leakage to the skin; C: CSDO migration after placement in an early leak after Roux-en-Y gastric bypass surgery. CSDO: Cardiac septal defect occluder.