A new approach for treatment of gastro-gastric fistula after gastric bypass

Gonzalo Torres-Villalobos, Daniel Leslie, Todd Kellogg, Rafael Andrade, Michael Maddaus, David Hunter, Sayeed Ikramuddin

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


We report a novel technique for gastro-gastric fistula (GGF) repair. A 44-year-old woman was found to have a fistula between her gastric pouch and bypassed stomach 18 years after Roux-en-Y gastric bypass (RYGBP) for morbid obesity. She underwent an attempted open surgical repair, which was complicated by postoperative abdominal sepsis. An upper gastrointestinal series, abdominal CT scan and upper endoscopy confirmed the diagnosis of failed surgery with recurrent GGF. Under endoscopic and fluoroscopic guidance, two ports were inserted percutaneously into the stomach. The fistula was closed with a percutaneous, transgastric, totally extraperitoneal approach. She remains well 7 months after this intervention. This procedure appears to be a safe and effective minimally invasive approach for closure of GGF after RYGBP. This is the first description of an intragastric, percutaneous closure of a GGF after RYGBP in the medical literature. Further experience with this technique is needed to define the selection criteria, limitations, advantages, and disadvantages.

Original languageEnglish (US)
Pages (from-to)242-246
Number of pages5
JournalObesity Surgery
Issue number2
StatePublished - Feb 2007

Bibliographical note

Copyright 2009 Elsevier B.V., All rights reserved.


  • Endoluminal laparoscopy
  • Gastric bypass
  • Gastro-gastric fistula
  • Intragastric
  • Minimally invasive surgery
  • Morbid obesity
  • Percutaneous
  • Transgastric surgery


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