Endoscopic Management of Weight Regain
Roux-en-Y gastric bypass (RYGB) is a commonly performed bariatric surgical procedure. Weight regain is common and multifactorial, with dilation of the gastrojejunal anastomosis (GJA) and possibly enlargement of the gastric pouch contributing factors for w
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Contents Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Endoscopic Suturing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Endoscopic Plication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Thermal (Heat/Cold) Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Cap-Mounted Clips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Abstract
Roux-en-Y gastric bypass (RYGB) is a commonly performed bariatric surgical procedure. Weight regain is common and multifactorial, with dilation of the gastrojejunal anastomosis (GJA) and possibly enlargement of the gastric pouch contributing factors for weight recidivism. Technological advancement in the field of bariatric endoscopy has led to several innovative approaches to manage these anatomic changes. This chapter will focus on available devices and techniques and review existing data and safety considerations of each.
A. R. Schulman Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA e-mail: [email protected] S. Edmundowicz (*) Division of Gastroenterology and Hepatology, University of Colorado School of Medicine, Aurora, CO, USA e-mail: [email protected]; [email protected] © Springer Nature Switzerland AG 2020 P. A. Testoni et al. (eds.), Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy, https://doi.org/10.1007/978-3-030-29964-4_48-1
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A. R. Schulman and S. Edmundowicz
Keywords
Roux-en-Y gastric bypass · Bariatric surgery · Weight regain · Weight recidivism · Endoscopy · Endoscopic revision · Transoral outlet reduction (TORe)
Introduction Roux-en-Y gastric bypass (RYGB) was traditionally the most common bariatric surgical procedure performed worldwide. This procedure involves partitioning the stomach to create a small gastric pouch approximately 30 mL in volume and reanastomosing it to a limb of small bowel, known as the Roux limb, to create a gastrojejunal anastomosis (GJA). Weight regain following RYGB is common and often accompanied by the recurrence of obesity-related comorbidities. Several st
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