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Obesity Surgery

, Volume 21, Issue 10, pp 1629–1633 | Cite as

The OTSC®-Clip in Revisional Endoscopy Against Weight Gain After Bariatric Gastric Bypass Surgery

  • Alex Marie Florent Heylen
  • Anja Jacobs
  • Monika Lybeer
  • Ruediger L. Prosst
New Concepts

Abstract

The maintenance of the restrictive component of the Fobi pouch gastric bypass is essential for permanent weight control. Dilatation of the pouch-outlet and of the pouch itself is responsible for substantial weight gain by an increased volume per meal and binge-eating due to the rapid emptying. An endoscopic over-the-scope clip (OTSC®; Ovesco AG, Tübingen, Germany) was applied in 94 patients following gastric bypass and unintended weight gain by dilated gastro-jejunostomy to narrow the pouch-outlet. The OTSC®-clip application was safe and efficient to reduce the pouch-outlet in all cases. Best clinical results were obtained by narrowing the gastro-jejunostomy by placing two clips at opposite sites, hence reducing the outlet of more than 80%. Preferably, the clip approximated the whole thickness of the wall to avoid further dilatation of the anastomosis. Between surgery and OTSC®-clip application the mean BMI dropped from 45.8 (±3.6) to 32.8 (±1.9). At the first follow-up about 3 months (mean 118 days, ±46 days) after OTSC®-clip application the mean BMI was 29.7 (±1.8). At the second follow-up about 1 year (mean 352 days, ±66 days) after OTSC®-clip application the mean BMI was 27.4 (±3.8). The OTSC®-clip for revisional endoscopy after gastric bypass is reliable and effective in treating weight gain due to a dilated pouch-outlet with favorable short- and midterm results.

Keywords

OTSC®-clip Fobi pouch gastric bypass Dilated pouch-outlet Dilated gastro-jejunostomy Bariatric surgery 

Notes

Conflict of interest

None.

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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Alex Marie Florent Heylen
    • 1
  • Anja Jacobs
    • 1
  • Monika Lybeer
    • 1
  • Ruediger L. Prosst
    • 2
  1. 1.St.-Ursula HospitalKuringenBelgium
  2. 2.Proctological Institute Stuttgart, Medicine and Medical Technology ConsultingStuttgartGermany

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