An innovative endoluminal rendezvous technique to restore gastrogastric continuity following extensive gastrointestinal loss from internal herniation.

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An innovative endoluminal rendezvous technique to restore gastrogastric continuity following extensive gastrointestinal loss from internal herniation after gastric bypass Darmarajah Veeramootoo, M.D., Andrew Wan, F.R.C.S., Georgios Vasilikostas, Ph.D. Surgery for Obesity and Related Diseases Volume 11, Issue 6, Pages e47-e50 (November 2015) DOI: 10.1016/j.soard.2015.01.013 Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 1 Antegrade endoscopy and rendezvous with guide wire passed through the gastrostomy. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 2 Critical endoscopic view of guide wire piercing into the pouch-stump complex. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 3 Dilation of the tract to allow passage of pigtail stent. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 4 Pigtail stent secured within pouch-stent complex. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 5 Antegrade contrast injection through the endoscope to confirm stent patency. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 6 Stent adequacy and position confirmed on final contrast study. Pooling of contrast in the dilated blind ending pouch-stump complex was apparent, but there was no clear suggestion of a leak and indeed none manifested clinically postprocedure. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions

Fig. 7 Check endoscopy to confirm successful restoration of gastrointestinal continuity. Surgery for Obesity and Related Diseases 2015 11, e47-e50DOI: (10.1016/j.soard.2015.01.013) Copyright © 2015 American Society for Bariatric Surgery Terms and Conditions