| Autor: |
Marta Mano Lopes, Dav Bansi, Vasha Kaur, Ahmed R. Ahmed, Jonathan Cousins, Ahmed Ghanem |
| Rok vydání: |
2019 |
| Předmět: |
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| Zdroj: |
Abstracts of Distinction. |
| DOI: |
10.1136/gutjnl-2019-bsgabstracts.25 |
| Popis: |
Introduction The Apollo OverStitch is a minimally invasive endoscopic suturing device which allows full thickness suturing without the need for surgery Roux-en-Y gastric bypass (RYGB) can achieve up to 60% weight loss 2 years after surgery but 30% of patients will regain their weight within 2 years. The options for this group of patients are limited; redo surgery can be challenging with a greater risk of complications. Endoscopic revision of the gastro-jejunal anastomosis using the Apollo OverStitch device now offers an alternative option in these patients to achieve further weight loss. Here we report our experience using this device, which is the largest patient cohort in the UK to date. Method Between April 2017 and December 2018, we have used the Apollo OverStitch device in 23 patients who had regained weight after an initial RVGB. All patients were discussed initially at our bariatric MDT. All patients underwent a prior gastroscopy to ensure a stoma size of at least 2 cm. All cases were done under general anaesthetic. Results Here we report the follow up data for our cohort. 91% of patients were females. Mean weight loss at early follow up (mean 82 days) was 6.7% and at late follow up (mean 342 days) was 9.9%. One patient had a re-do procedure, having dropped from 104 kg to 95 kg and then further to 88.8 kg. There were no procedure related complications. Conclusion Endoscopic revision of the RYGB stoma using the Apollo OverStitch device is an effective method of achieving further weight loss in these patients. The effects are sustained at 1 year. We are now developing our technique to incorporate more bites for each suture placed, as well as following the first line of sutures with a second in order to achieve a tighter effect on reducing the stoma size. We have done a further 7 patients since, making our cohort the largest in the UK. We propose that this management option be considered in all patients with weight regain after RYGB and a gastro-jejunal stoma >2 cm at gastroscopy. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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