Skip to main content
SpringerLink
Log in

Indications of Endoscopy in the Obese Patient

  • Chapter
  • First Online:
Endoscopy in Obesity Management

  • 572 Accesses

Abstract

Obesity increases the probability of many gastrointestinal conditions, from benign foregut pathology to colorectal cancer. Since colonoscopy is a standard screening test for colorectal cancer, the criteria for screening are well established and understood by the general medical community. Upper endoscopic indications, however, are not as readily known and are more dependent on a patient’s medical history and symptoms. This chapter will focus on understanding how obesity as an independent risk factor should affect our choice in performing upper and lower endoscopy, and its role in the management of bariatric patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Levin B, Lieberman DA, McFarland B, Smith RA, Brooks D, Andrews KS, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US multi-society task force on colorectal cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58(3):130–60.

    Article  PubMed  Google Scholar 

  2. Evans JA, Early DS, Fukami N, Ben-Menachem T, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in Barrett’s esophagus and other premalignant conditions of the esophagus. Gastrointest Endosc. 2012;76(6):1087–94.

    Article  PubMed  Google Scholar 

  3. Talley NJ, Walker MM, Holtmann G. Functional dyspepsia. Curr Opin Gastroenterol. 2016;32(6):467–73.

    Article  CAS  PubMed  Google Scholar 

  4. Shaukat A, Wang A, Acosta RD, Bruining DH, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in dyspepsia. Gastrointest Endosc. 2015;82(2):227–32.

    Article  PubMed  Google Scholar 

  5. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus G. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol. 2006;101(8):1900–20.

    Article  PubMed  Google Scholar 

  6. Muthusamy VR, Lightdale JR, Acosta RD, Chandrasekhara V, Chathadi KV, Eloubeidi MA, et al. The role of endoscopy in the management of GERD. Gastrointest Endosc. 2015;81(6):1305–10.

    Article  PubMed  Google Scholar 

  7. Hvid-Jensen F, Pedersen L, Drewes AM, Sorensen HT, Funch-Jensen P. Incidence of adenocarcinoma among patients with Barrett’s esophagus. N Engl J Med. 2011;365(15):1375–83.

    Article  CAS  PubMed  Google Scholar 

  8. Lee J, Wong SK, Liu SY, Ng EK. Is preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery mandatory? An Asian perspective. Obes Surg. 2017;27(1):44–50.

    Article  PubMed  Google Scholar 

  9. Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FKL, Furberg CD, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use: a report of the American College of Cardiology Foundation task force on clinical expert consensus documents. J Am Coll Cardiol. 2008;52(18):1502.

    Article  PubMed  Google Scholar 

  10. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143(3):199–211.

    Article  PubMed  Google Scholar 

  11. Wilson LJ, Ma M, Hirschowitz BI. Association of obesity with hiatal hernia and esophagitis. Am J Gastroenterol. 1999;94(10):2840–4.

    Article  CAS  PubMed  Google Scholar 

  12. Yamamoto S, Watabe K, Takehara T. Is obesity a new risk factor for gastritis? Digestion. 2012;85(2):108–10.

    Article  PubMed  Google Scholar 

  13. Yamamoto S, Watabe K, Tsutsui S, Kiso S, Hamasaki T, Kato M, et al. Lower serum level of adiponectin is associated with increased risk of endoscopic erosive gastritis. Dig Dis Sci. 2011;56(8):2354–60.

    Article  CAS  PubMed  Google Scholar 

  14. Aro P, Storskrubb T, Ronkainen J, Bolling-Sternevald E, Engstrand L, Vieth M, et al. Peptic ulcer disease in a general adult population: the Kalixanda study: a random population-based study. Am J Epidemiol. 2006;163(11):1025–34.

    Article  PubMed  Google Scholar 

  15. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4(8):579–91.

    Article  CAS  PubMed  Google Scholar 

  16. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.

    Article  PubMed  Google Scholar 

  17. Wu AH, Tseng CC, Bernstein L. Hiatal hernia, reflux symptoms, body size, and risk of esophageal and gastric adenocarcinoma. Cancer. 2003;98(5):940–8.

    Article  PubMed  Google Scholar 

  18. Arslan E, Atılgan H, Yavaşoğlu İ. The prevalence of Helicobacter pylori in obese subjects. Eur J Intern Med. 2009;20(7):695–7.

    Article  PubMed  Google Scholar 

  19. Erim T, Cruz-Correa MR, Szomstein S, Velis E, Rosenthal R. Prevalence of Helicobacter pylori seropositivity among patients undergoing bariatric surgery: a preliminary study. World J Surg. 2008;32(9):2021–5.

    Article  PubMed  Google Scholar 

  20. Papasavas PK, Gagné DJ, Donnelly PE, Salgado J, Urbandt JE, Burton KK, et al. Prevalence of Helicobacter pylori infection and value of preoperative testing and treatment in patients undergoing laparoscopic roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(3):383–8.

    Article  PubMed  Google Scholar 

  21. Schirmer B, Erenoglu C, Miller A. Flexible endoscopy in the management of patients undergoing roux-en-Y gastric bypass. Obes Surg. 2002;12(5):634–8.

    Article  PubMed  Google Scholar 

  22. Zeni TM, Frantzides CT, Mahr C, Denham EW, Meiselman M, Goldberg MJ, et al. Value of preoperative upper endoscopy in patients undergoing laparoscopic gastric bypass. Obes Surg. 2006;16(2):142–6.

    Article  PubMed  Google Scholar 

  23. de Moura AA, Cotrim HP, Santos AS, Bitencourt AGV, Barbosa DBV, Lobo AP, et al. Preoperative upper gastrointestinal endoscopy in obese patients undergoing bariatric surgery: is it necessary? Surg Obes Relat Dis. 2008;4(2):144–9.

    Article  Google Scholar 

  24. Greenwald D. Preoperative gastrointestinal assessment before bariatric surgery. Gastroenterol Clin N Am. 2010;39(1):81–6.

    Article  Google Scholar 

  25. Loewen M, Giovanni J, Barba C. Screening endoscopy before bariatric surgery: a series of 448 patients. Surg Obes Relat Dis. 2008;4(6):709–12.

    Article  PubMed  Google Scholar 

  26. Schigt A, Coblijn U, Lagarde S, Kuiken S, Scholten P, van Wagensveld B. Is esophagogastroduodenoscopy before Roux-en-Y gastric bypass or sleeve gastrectomy mandatory? Surg Obes Relat Dis. 2014;10(3):411–7; quiz 565–6.

    Google Scholar 

  27. Mong C, Van Dam J, Morton J, Gerson L, Curet M, Banerjee S. Preoperative endoscopic screening for laparoscopic roux-en-Y gastric bypass has a low yield for anatomic findings. Obes Surg. 2008;18(9):1067–73.

    Article  PubMed  Google Scholar 

  28. Korenkov M, Sauerland S, Shah S, Junginger T. Is routine preoperative upper endoscopy in gastric banding patients really necessary? Obes Surg. 2006;16(1):45–7.

    Article  PubMed  Google Scholar 

  29. Stenberg E, Szabo E, Agren G, Naslund E, Boman L, Bylund A, et al. Early complications after laparoscopic gastric bypass surgery: results from the Scandinavian obesity surgery registry. Ann Surg. 2014;260(6):1040–7.

    Article  PubMed  Google Scholar 

  30. Kim J, Azagury D, Eisenberg D, DeMaria E, Campos GM. ASMBS position statement on prevention, detection, and treatment of gastrointestinal leak after gastric bypass and sleeve gastrectomy, including the roles of imaging, surgical exploration, and nonoperative management. Surg Obes Relat Dis. 2015;11(4):739–48.

    Article  PubMed  Google Scholar 

  31. Champion JK, Hunt T, DeLisle N. Role of routine intraoperative endoscopy in laparoscopic bariatric surgery. Surg Endosc. 2002;16(12):1663–5.

    Article  CAS  PubMed  Google Scholar 

  32. Haddad A, Tapazoglou N, Singh K, Averbach A. Role of intraoperative esophagogastroenteroscopy in minimizing gastrojejunostomy-related morbidity: experience with 2,311 laparoscopic gastric bypasses with linear stapler anastomosis. Obes Surg. 2012;22(12):1928–33.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Sekhar N, Torquati A, Lutfi R, Richards WO. Endoscopic evaluation of the gastrojejunostomy in laparoscopic gastric bypass: a series of 340 patients without postoperative leak. Surg Endosc. 2006;20(2):199–201.

    Article  CAS  PubMed  Google Scholar 

  34. Alasfar F, Chand B. Intraoperative endoscopy for laparoscopic roux-en-Y gastric bypass: leak test and beyond. Surg Laparosc Endosc Percutan Tech. 2010;20(6):424–7.

    Article  PubMed  Google Scholar 

  35. Frezza EE, Barton A, Herbert H, Wachtel MS. Laparoscopic sleeve gastrectomy with endoscopic guidance in morbid obesity. Surg Obes Relat Dis. 2008;4(5):575–9.

    Article  PubMed  Google Scholar 

  36. Andreas A, Adamantios M, Antonios A, Theofilos R, Christos T, Theodoros D. Laparoscopic sleeve gastrectomy for morbid obesity with intra-operative endoscopy: lessons we learned after 100 consecutive patients. Obes Surg. 2015;25(7):1223–8.

    Article  PubMed  Google Scholar 

  37. Bellanger DE, Greenway FL. Laparoscopic sleeve gastrectomy, 529 cases without a leak: short-term results and technical considerations. Obes Surg. 2011;21(2):146–50.

    Article  PubMed  Google Scholar 

  38. Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18(9):1083–8.

    Article  PubMed  Google Scholar 

  39. Sakran N, Goitein D, Raziel A, Keidar A, Beglaibter N, Grinbaum R, et al. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2,834 patients. Surg Endosc. 2013;27(1):240–5.

    Article  PubMed  Google Scholar 

  40. Sethi M, Zagzag J, Patel K, Magrath M, Somoza E, Parikh MS, et al. Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30(3):883–91.

    Article  PubMed  Google Scholar 

  41. Ponce J, Nguyen NT, Hutter M, Sudan R, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of bariatric surgery procedures in the United States, 2011-2014. Surg Obes Relat Dis. 2015;11(6):1199–200.

    Article  PubMed  Google Scholar 

  42. Singhal R, Bryant C, Kitchen M, Khan KS, Deeks J, Guo B, et al. Band slippage and erosion after laparoscopic gastric banding: a meta-analysis. Surg Endosc. 2010;24(12):2980–6.

    Article  PubMed  Google Scholar 

  43. Owers C, Ackroyd R. A study examining the complications associated with gastric banding. Obes Surg. 2013;23(1):56–9.

    Article  PubMed  Google Scholar 

  44. Evans JA, Muthusamy VR, Acosta RD, Bruining DH, Chandrasekhara V, Chathadi KV, et al. The role of endoscopy in the bariatric surgery patient. Gastrointest Endosc. 2015;81(5):1063–72.

    Article  PubMed  Google Scholar 

  45. Lattuada E, Zappa MA, Mozzi E, Fichera G, Granelli P, Ruberto FD, et al. Band erosion following gastric banding: how to treat it. Obes Surg. 2007;17(3):329–33.

    Article  PubMed  Google Scholar 

  46. Varban OA, Cassidy RB, Sheetz KH, Cain-Nielsen A, Carlin AM, Schram JL, et al. Technique or technology? Evaluating leaks after gastric bypass. Surg Obes Relat Dis. 2016;12(2):264–72.

    Article  PubMed  Google Scholar 

  47. Fullum TM, Aluka KJ, Turner PL. Decreasing anastomotic and staple line leaks after laparoscopic roux-en-Y gastric bypass. Surg Endosc. 2009;23(6):1403–8.

    Article  PubMed  Google Scholar 

  48. Schiesser M, Kressig P, Bueter M, Nocito A, Bauerfeind P, Gubler C. Successful endoscopic management of gastrointestinal leakages after laparoscopic roux-en-Y gastric bypass surgery. Dig Surg. 2014;31(1):67–70.

    Article  PubMed  Google Scholar 

  49. van Wezenbeek MR, de Milliano MM, Nienhuijs SW, Friederich P, Gilissen LP. A specifically designed stent for anastomotic leaks after bariatric surgery: experiences in a tertiary referral hospital. Obes Surg. 2016;26(8):1875–80.

    Article  PubMed  Google Scholar 

  50. Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75(2):287–93.

    Article  PubMed  Google Scholar 

  51. Murino A, Arvanitakis M, Le Moine O, Blero D, Devière J, Eisendrath P. Effectiveness of endoscopic management using self-expandable metal stents in a large cohort of patients with post-bariatric leaks. Obes Surg. 2015;25(9):1569–76.

    Article  PubMed  Google Scholar 

  52. Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy a systematic review and meta-analysis of 9,991 cases. Ann Surg. 2013;257(2):231–7.

    Article  PubMed  Google Scholar 

  53. Simon F, Siciliano I, Gillet A, Castel B, Coffin B, Msika S. Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time. Obes Surg. 2013;23(5):687–92.

    Article  CAS  PubMed  Google Scholar 

  54. Alazmi W, Al-Sabah S, Ali DA, Almazeedi S. Treating sleeve gastrectomy leak with endoscopic stenting: the kuwaiti experience and review of recent literature. Surg Endosc. 2014;28(12):3425–8.

    Article  PubMed  Google Scholar 

  55. Donatelli G, Ferretti S, Vergeau BM, Dhumane P, Dumont J-L, Derhy S, et al. Endoscopic internal drainage with enteral nutrition (EDEN) for treatment of leaks following sleeve gastrectomy. Obes Surg. 2014;24(8):1400–7.

    Article  PubMed  Google Scholar 

  56. Higa KD, Boone KB, Ho T. Complications of the laparoscopic roux-en-y gastric bypass: 1,040 patients—what have we learned? Obes Surg. 2000;10(6):509–13.

    Article  CAS  PubMed  Google Scholar 

  57. Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J. Outcomes after laparoscopic roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Nguyen NT, Stevens CM, Wolfe BM. Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass. J Gastrointest Surg. 2003;7(8):997–1003; discussion.

    Google Scholar 

  59. Barba CA, Butensky MS, Lorenzo M, Newman R. Endoscopic dilation of gastroesophageal anastomosis stricture after gastric bypass. Surg Endosc. 2003;17(3):416–20.

    Article  CAS  PubMed  Google Scholar 

  60. Takata MC, Ciovica R, Cello JP, Posselt AM, Rogers SJ, Campos GM. Predictors, treatment, and outcomes of gastrojejunostomy stricture after gastric bypass for morbid obesity. Obes Surg. 2007;17(7):878–84.

    Article  PubMed  Google Scholar 

  61. Ukleja A, Afonso BB, Pimentel R, Szomstein S, Rosenthal R. Outcome of endoscopic balloon dilation of strictures after laparoscopic gastric bypass. Surg Endosc. 2008;22(8):1746–50.

    Article  PubMed  Google Scholar 

  62. Ryskina KL, Miller KM, Aisenberg J, Herron DM, Kini SU. Routine management of stricture after gastric bypass and predictors of subsequent weight loss. Surg Endosc. 2010;24(3):554–60.

    Article  PubMed  Google Scholar 

  63. Tobin RW. Esophageal rings, webs, and diverticula. J Clin Gastroenterol. 1998;27(4):285–95.

    Article  CAS  PubMed  Google Scholar 

  64. Escalona A, Devaud N, Boza C, Pérez G, Fernández J, Ibáñez L, et al. Gastrojejunal anastomotic stricture after roux-en-Y gastric bypass: ambulatory management with the Savary–Gilliard dilator. Surg Endosc. 2007;21(5):765–8.

    Article  CAS  PubMed  Google Scholar 

  65. Cusati D, Sarr M, Kendrick M, Que F, Swain JM. Refractory strictures after roux-en-Y gastric bypass: operative management. Surg Obes Relat Dis. 2011;7(2):165–9.

    Article  PubMed  Google Scholar 

  66. Uchima H, Abu-Suboh M, Mata A, Cruz M, Espinos J. Lumen-apposing metal stent for the treatment of refractory gastrojejunal anastomotic stricture after laparoscopic gastric bypass. Gastrointest Endosc. 2016;83(1):251.

    Article  PubMed  Google Scholar 

  67. Marcotte E, Comeau E, Meziat-Burdin A, Ménard C, Rateb G. Early migration of fully covered double-layered metallic stents for post-gastric bypass anastomotic strictures. Int J Surg Case Rep. 2012;3(7):283–6.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Yimcharoen P, Heneghan HM, Tariq N, Brethauer SA, Kroh M, Chand B. Endoscopic stent management of leaks and anastomotic strictures after foregut surgery. Surg Obes Relat Dis. 2011;7(5):628–36.

    Article  PubMed  Google Scholar 

  69. Manos T, Nedelcu M, Cotirlet A, Eddbali I, Gagner M, Noel P. How to treat stenosis after sleeve gastrectomy? Surg Obes Relat Dis. 2017;13(2):150–4.

    Article  PubMed  Google Scholar 

  70. Donatelli G, Dumont J-L, Pourcher G, Tranchart H, Tuszynski T, Dagher I, et al. Pneumatic dilation for functional helix stenosis after sleeve gastrectomy: long-term follow-up (with videos). Surg Obes Relat Dis. 2016;13(6):943–50. http://dx.doi.org/10.1016/j.soard.2016.09.023

    Article  PubMed  Google Scholar 

  71. El-Hayek K, Timratana P, Shimizu H, Chand B. Marginal ulcer after roux-en-Y gastric bypass: what have we really learned? Surg Endosc. 2012;26(10):2789–96.

    Article  CAS  PubMed  Google Scholar 

  72. Gumbs AA, Duffy AJ, Bell RL. Incidence and management of marginal ulceration after laparoscopic roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;2(4):460–3.

    Article  PubMed  Google Scholar 

  73. Moon RC, Teixeira AF, Goldbach M, Jawad MA. Management and treatment outcomes of marginal ulcers after roux-en-Y gastric bypass at a single high volume bariatric center. Surg Obes Relat Dis. 2014;10(2):229–34.

    Article  PubMed  Google Scholar 

  74. Azagury DE, Abu Dayyeh BK, Greenwalt IT, Thompson CC. Marginal ulceration after roux-en-Y gastric bypass surgery: characteristics, risk factors, treatment, and outcomes. Endoscopy. 2011;43(11):950–4.

    Article  CAS  PubMed  Google Scholar 

  75. Lee YC, Wang HP, Yang CS, Yang TH, Chen JH, Lin CC, et al. Endoscopic hemostasis of a bleeding marginal ulcer: hemoclipping or dual therapy with epinephrine injection and heater probe thermocoagulation. J Gastroenterol Hepatol. 2002;17(11):1220–5.

    Article  PubMed  Google Scholar 

  76. Niland B, Brock A. Over-the-scope clip for endoscopic closure of gastrogastric fistulae. Surg Obes Relat Dis. 2017;13(1):15–20.

    Article  PubMed  Google Scholar 

  77. Mukewar S, Kumar N, Catalano M, Thompson C, Abidi W, Harmsen W, et al. Safety and efficacy of fistula closure by endoscopic suturing: a multi-center study. Endoscopy. 2016;48(11):1023–8.

    Article  PubMed  Google Scholar 

  78. Fernandez-Esparrach G, Lautz DB, Thompson CC. Endoscopic repair of gastrogastric fistula after roux-en-Y gastric bypass: a less-invasive approach. Surg Obes Relat Dis. 2010;6(3):282–8.

    Article  PubMed  Google Scholar 

  79. Mikami D, Needleman B, Narula V, Durant J, Melvin WS. Natural orifice surgery: initial U.S. experience utilizing the StomaphyXTM device to reduce gastric pouches after roux-en-Y gastric bypass. Surg Endosc. 2010;24(1):223–8.

    Article  PubMed  Google Scholar 

  80. Goyal V, Holover S, Garber S. Gastric pouch reduction using StomaphyX™ in post roux-en-Y gastric bypass patients does not result in sustained weight loss: a retrospective analysis. Surg Endosc. 2013;27(9):3417–20.

    Article  PubMed  Google Scholar 

  81. Thompson CC, Chand B, Chen YK, Demarco DC, Miller L, Schweitzer M, et al. Endoscopic suturing for transoral outlet reduction increases weight loss after roux-en-Y gastric bypass surgery. Gastroenterology. 2013;145(1):129–137.e3.

    Article  PubMed  Google Scholar 

  82. Baretta GAP, Alhinho HCAW, Matias JEF, Marchesini JB, de Lima JHF, Empinotti C, et al. Argon plasma coagulation of gastrojejunal anastomosis for weight regain after gastric bypass. Obes Surg. 2015;25(1):72–9.

    Article  PubMed  Google Scholar 

  83. Riva P, Perretta S, Swanstrom L. Weight regain following RYGB can be effectively treated using a combination of endoscopic suturing and sclerotherapy. Surg Endosc. 2017;31(4):1891–5.

    Article  PubMed  Google Scholar 

  84. Jirapinyo P, Dayyeh BKA, Thompson CC. Gastrojejunal anastomotic reduction for weight regain in roux-en-Y gastric bypass patients: physiological, behavioral, and anatomical effects of endoscopic suturing and sclerotherapy. Surg Obes Relat Dis. 2016;12(10):1810–6.

    Article  PubMed  Google Scholar 

  85. Fobi MAL, Chicola K, Lee H. Access to the bypassed stomach after gastric bypass. Obes Surg. 1998;8(3):289–95.

    Article  CAS  PubMed  Google Scholar 

  86. Sakai P, Kuga R, Safatle-Ribeiro AV, Faintuch J, Gama-Rodrigues JJ, Ishida RK, et al. Is it feasible to reach the bypassed stomach after roux-en-Y gastric bypass for morbid obesity? The use of the double-balloon enteroscope. Endoscopy. 2005;37(6):566.

    Article  CAS  PubMed  Google Scholar 

  87. Ceppa FA, Gagné DJ, Papasavas PK, Caushaj PF. Laparoscopic transgastric endoscopy after roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3(1):21–4.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Surgery, University of California at Davis, 4223 J St, Unit #3, Sacramento, CA, 95819, USA

    Jawad Tahir Ali M.D.

  2. Department of Surgery, University of California, Davis Medical Center, 2221 Stockton Boulevard, Sacramento, CA, 95817, USA

    Jawad Tahir Ali M.D. & Aaron D. Carr M.D.

Authors
  1. Jawad Tahir Ali M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Aaron D. Carr M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Aaron D. Carr M.D. .

Editor information

Editors and Affiliations

  1. Gastrointestinal/Minimally Invasive Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois, USA

    Bipan Chand

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Ali, J.T., Carr, A.D. (2018). Indications of Endoscopy in the Obese Patient. In: Chand, B. (eds) Endoscopy in Obesity Management. Springer, Cham. https://doi.org/10.1007/978-3-319-63528-6_2

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-63528-6_2

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63527-9

  • Online ISBN: 978-3-319-63528-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation