Laparoscopically assisted transgastric endoscopy in Roux-en-Y gastric bypass: a modification of the technique

Abstract

Laparoscopically assisted transgastric endoscopy is a well-accepted strategy to access the papilla of Vater in patients with a bypassed duodenum, as after Roux-en-Y gastric bypass [1] [2] [3]. In this technique the endoscope is introduced into the abdomen through a trocar and is advanced to the duodenum via a gastrotomy. Using this technique however, gastric fluid and endoscopic insufflated air might escape from the gastrotomy during manipulation of the endoscope. The presence of gastric contents inside the peritoneal cavity might cause peritonitis or abscess formation. The presence of insufflated room air in the peritoneal cavity could cause dangerous gas embolisms [4] [5].