Current applications of endoscopic suturing

Figure 6 Endoscopic revision of gastrojejunal anastomosis in gastric bypass patient. A: An enlarged gastrojejunal anastomosis is noted; B and C: Argon plasma coagulation was used around the stoma to ablate the mucosa and facilitate tissue fusion during the healing process; D: Two sutures were used obtaining circumferential tissue bites to achieve a purse-like closure of the stoma; E: A 10 mm controlled radial expansion balloon was dilated and placed through the stoma opening via the second channel of the double-channel therapeutic endoscope and then the sutures were tightened so that the final stoma diameter was approximately 10 mm in size; F and G: The balloon was then deflated and removed. A markedly diminished stoma orifice is seen at the end of the procedure.