# Stent-Over-Sponge (SOS) as a Rescue Technique for Leak Post-Bariatric Surgery: Experience From Hôpital du Sacré-Coeur, Canada

## TL;DR

A new technique called SOS is used to treat leaks after bariatric surgery when other methods fail, showing promise in a patient's recovery.

## Contribution

The SOS technique is introduced as a novel rescue method for post-bariatric surgery leaks.

## Key findings

- The SOS technique successfully closed a post-operative leak in a patient.
- The patient remained asymptomatic six months after treatment.
- The SOS method shows potential for managing difficult post-surgery complications.

## Abstract

Leaks and fistulas are serious complications following gastrointestinal surgeries, traditionally managed by self-expandable metal stents and endoscopic vacuum therapy. The stent-over-sponge (SOS) technique is a new modality used as a rescue option when other interventions fail.

This report presents the case of a 60-year-old female patient who underwent revisional bariatric surgery and developed a leak post-operation. Initial management included endoscopic debridement and the placement of an Endo-VAC system. Due to technical difficulties, the sponge was left in an endoluminal position, leading to migration. A partially covered stent was placed to prevent further migration and facilitate healing. The patient experienced complications, including hematemesis, but ultimately achieved complete leak closure and is asymptomatic six months post-treatment.

In this case, the SOS technique demonstrates its safety and efficacy in dealing with post-operative leaks in patients having undergone bariatric surgery, which would justify performing more extended evaluative studies.