Endoscopic reversal of the modified Long vertical gastroplasty

TL;DR

This paper describes a safe endoscopic method to reverse a bariatric surgery called modified Long vertical gastroplasty, which helps alleviate complications like reflux and swallowing issues.

Contribution

The novel use of an endoscopic stent to reverse a modified Long vertical gastroplasty is introduced as a safer alternative to surgery.

Findings

Endoscopic reversal using a stent effectively treated reflux and dysphagia in a patient.

The stent allowed dilation of strictures and endoscopic removal of eroded sutures.

This method is presented as a safe alternative to traditional surgical reversal.

Abstract

Endoscopic techniques are revolutionizing bariatric surgery because of the significant risks that obesity places on both anaesthesia and surgery. Due to the high number of long-term complications that may be associated with bariatric surgery, and the relative safety of endoscopy compared to operative management, endoscopic methods for reversal of previous bariatric techniques are becoming the favoured approach. We describe the use of an endoscopic stent to assist with endoscopic reversal of a modified Long vertical gastroplasty. The modified Long vertical gastroplasty was a restrictive bariatric procedure that was effective to promote weight loss, but had adverse effects including dysphagia, reflux, indigestion and weight regain. The use of an adjunct stent not only treated the patient’s reflux by dilating the stricture but allowed for erosion of the sutures intra-luminally to be removed endoscopically. The endoscopic reversal of this technique is safe and helped to relieve the patient’s symptoms of reflux and dysphagia.

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