Role of endoscopy in the bariatric surgery of patients

Figure 1 Patient with late hemorrhage after Roux-en-Y gastric bypass: endoscopic view shows a marginal ulceration with a visible vessel at the base of the lesion.

Figure 2 Multiple erosions in the anastomosed jejunum.

Figure 3 Patient with fistula after sleeve gastrectomy. A: Endoscopic view of fistula at the upper portion of staple line in a patient after laparoscopic sleeve gastrectomy; a clip is visible on the boundary of the fistulous orifice as a result of a unsuccessful previous attempt at treatment; B: Fully covered removable stent (Taewoong Niti-S™ esophageal Mega stent) was implanted, promoting healing of the fistula.

Figure 4 Different steps of endoscopic Lap-Band extraction. A: Endoscopic view of an almost penetrated band, with only a small tissue bridge holding the device to the gastric wall; B: Endoscopic view of the AMI gastric band cutter (CJ Medical, Haddenham, United Kingdom) passed around the band after endoscopic resection of the tissue bridge; C: After the section, the band is grasped at the connection with the port-site, and extracted through the mouth; D: Gastric pouch outlet aspect after ring extraction (retrovision from the stomach).

Figure 5 Laparoscopic assisted endoscopic retrograde cholangiopancreatography after Roux-en-Y gastric bypass. A side-viewing endoscope is inserted through a 15-mm trocar that was previously placed into the excluded stomach. Subsequently, endoscopic retrograde cholangiopancreatography is performed in the usual fashion.