Obesity Surgery

, Volume 18, Issue 3, pp 336–339 | Cite as

Use of Flexible Endoscopic Scissors to Cut Obstructing Suture Material in Gastric Bypass Patients

  • Chirag Patel
  • Jacques Van Dam
  • Myriam Curet
  • John M Morton
  • Subhas Banerjee
Case Reports

Abstract

With the epidemic increase in obesity in the USA and consequent increased demand for bariatric surgery, new complications of the surgery are being described. The most common surgery practiced is the Roux-en-Y gastric bypass (RYGBP). Unraveling of suture material at the gastrojejunal anastomosis may occur, which may be troublesome if nonabsorbable suture is employed. We describe, for the first time, two patients who developed obstructive symptoms as a consequence of food matter/bezoars entrapped within a mesh of unraveled nonabsorbable suture material at their anastomoses. One of these patients also developed ulceration, presumably as a result of pressure necrosis from the entrapped bezoar. We describe a third patient where the placement of nonabsorbable sutures led to obstructive symptoms by limiting distensibility at an otherwise satisfactory anastomosis. We also describe for the first time, the use of a new endoscopic scissors in cutting luminal suture material with subsequent resolution of the clinical problem.

Keywords

Bariatric surgery Gastric outlet obstruction Endoscopic scissors 

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Copyright information

© Springer Science + Business Media B.V. 2007

Authors and Affiliations

  • Chirag Patel
    • 1
  • Jacques Van Dam
    • 1
  • Myriam Curet
    • 2
  • John M Morton
    • 2
  • Subhas Banerjee
    • 3
  1. 1.Department of MedicineStanford University School of MedicineStanfordUSA
  2. 2.Department of SurgeryStanford University School of MedicineStanfordUSA
  3. 3.Division of Gastroenterology and HepatologyStanford University Medical CenterStanfordUSA

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