Endoscopic Suture Revision of dilated stoma (gastrojejunostomy anastamosis) after Roux-en-Y gastric bypass weight loss surgery:
Case 1:
Top left; ablative de-epithelization of dilated stoma, top right preparing for first suture placement, bottom left afer first figure of eight suture cinched and bottom right end result with stoma reduction.
Case 2:
Markedly dilated stoma approx 4 cms
Ablative de-epithelization of mucosa at anastamosis
Endoscopic Suturing with Apollo Overstitch
Anchoring of final suture
After final cinched suture
Final appearance of stoma size reduction to approx 12 mm
Endoscopic suture fixation of fully covered esophageal metal stent:
Refractory gastroesophageal anastamotic stricture
Balloon catheter through stricture
Balloon dilation of fibrotic stricture
Severe fibrosis of anastamotic stricture
Endoscopic suture fixation of proximal end of stent in the esophagus, 1st suture placement with Apollo Overstitch device
Appearance after first complete suture cinched
Appearance after 2 cinched sutures have been secured and preparation for a 3rd suture.
Final appearance after placement of 3 separately cinched sutures securing the proximal end of the fully covered stent to prevent distal migration.