Виртуальный университет

In 2004, a 57-year-old lady underwent a Roux-en-Y gastric bypass (RYGB) for morbid obesity. After the surgical intervention, she lost 13Kg and she started to regain weight back with a current BMI of 41.
During this live procedure, Professor Perretta performs a gastroscopy that shows a normal gastric pouch and a gastrojejunal anastomosis increased in caliber. The operator does an endoscopic resizing of the anastomosis with Argon Plasma Coagulation (APC) followed by the placement of an endoscopic suture with the Apollo OverStitch™ endoscopic suturing system.

An 82-year-old man underwent an emergency endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis secondary to choledocholithiasis 11 days earlier. At that time, since the patient was under Clopidogrel, the sphincterotomy was not performed and a plastic stent was released in the common bile duct (CBD) to bypass the stones. In this live procedure, Dr. Boškoski performs an ERCP with sphincterotomy and biliary stones extraction. During the procedure, the operator gives every fundamental tips and tricks to perform the correct procedure. At the end of the intervention, a 3D cholangiography is performed to confirm complete biliary stones extraction.

In this live procedure, Professor Perretta performs an endoscopic sleeve gastroplasty (ESG) using the OverStitch™ endoscopic suturing system (Apollo Endosurgery) in a 50-year-old obese male patient (with a BMI of 35.3). In this particular case, preoperative esophagogastroduodenoscopy (EGD) showed a Barrett’s esophagus with positive histology for intestinal metaplasia, which is not a contraindication for this kind of endoscopic intervention. ESG is performed with the patient under general anesthesia and carbon dioxide insufflation. The supine position is preferred because it is safer than the left lateral decubitus position as it allows for a better exposure of the stomach. Sutures are placed in a U-shaped fashion from the incisura angularis to the fundus, which is spared using the OverStitch™ suturing system, mounted on a double channel Olympus scope. The system allows for the placement of durable full-thickness stitches to obtain gastric volume reduction and shrinking.