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Endoscopic Plication and Reduction of the Gastric Pouch in Patients who Previously Underwent Gastric Bypass Surgery Chiranjiv S Virk MD,  Dimitrios V. Avgerinos, MD, Radha Patel,  Burton Surick, MD, John L. Holup, DO, Elliot R. Goodman, MD and I. Michael Leitman, MD Department of Surgery Beth Israel Medical Center New York, NY
Commercial Disclosures: ,[object Object],[object Object]
Background ,[object Object],[object Object],[object Object],Pories WJ, Swanson MS, MacDonald KG.  Who would have thought it?  An operation proves to be the most effective therapy for adult-onset diabetes mellitus.  Ann Surg 1995;222:339-350.
Background ,[object Object],[object Object],[object Object],Gagner M., et al.  Laparoscopic Reoperative Bariatric Surgery :  Experience from 27 consecutive patients.  Obes Surg, (12) 254-260, 2002.
Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Jones KB. Revisional bariatric Surgery-potentially safe and effective.  SOARDS 1 (2005) 599-603
Background ,[object Object],[object Object]
Complications of Revisional Surgery: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Goal: ,[object Object]
Endoluminal Gastric Pouch Reduction ,[object Object],[object Object],[object Object],[object Object]
Methods: ,[object Object],[object Object],[object Object]
Endoluminal Gastric Pouch Reduction ,[object Object],[object Object],[object Object],[object Object],[object Object]
Procedure: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagram for fasteners H H H H H H
Serosa-to-serosa Fusion Full thickness tissue plication and serosa-to-serosa  fusion seen in several animal models
Endoluminal Gastric Pouch Reduction
[object Object]
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Sls 01

  • 1. Endoscopic Plication and Reduction of the Gastric Pouch in Patients who Previously Underwent Gastric Bypass Surgery Chiranjiv S Virk MD, Dimitrios V. Avgerinos, MD, Radha Patel, Burton Surick, MD, John L. Holup, DO, Elliot R. Goodman, MD and I. Michael Leitman, MD Department of Surgery Beth Israel Medical Center New York, NY
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13. Diagram for fasteners H H H H H H
  • 14. Serosa-to-serosa Fusion Full thickness tissue plication and serosa-to-serosa fusion seen in several animal models
  • 16.