Background: Retained suture material from primary Roux-en-Y gastric bypass or revisions may result in local inflammation, ulcer formation, and abdominal pain. The primary aim of this study was to evaluate the feasibility, efficacy, and safety of novel, disposable endoscopic scissors for suture removal.
Methods: This was a single-center, retrospective analysis of prospectively collected data from December 2016 to January 2019. Patients with history of Roux-en-Y gastric bypass and upper endoscopy utilizing this novel, disposable endoscopic scissors device were reviewed. Measured outcomes included endoscopy indication, technical success (as determined by ability to achieve adequate cut and suture removal), improvement in abdominal pain if present prior to procedure, and adverse events.
Results: Sixty-two patients were included in this analysis. Mean age was 54.69 ± 9.40 years. Eighty-eight percent of patients were female. Roux-en-Y gastric bypass occurred on average 142.43 ± 62.33 months prior to suture removal. Primary indications for endoscopy were evaluation of gastric pouch and gastrojejunal anastomosis for weight regain (37.10%) and abdominal pain (30.65%). Overall, technical success of these novel endoscopic scissors was 100% with a mean procedure duration of 23.00 ± 9.50 min. Symptom improvement post-suture removal occurred in approximately half of the patients (48.65%). Post-procedure bleeding was self-limited and occurred in 2 patients (3.23%). Two patients developed transient post-procedure abdominal pain.
Conclusions: Novel, disposable endoscopic scissors appear to be highly effective and safe for removal of suture material with high technical success and minimal adverse events.
Keywords: Endoscopic scissors; Endoscopy; Obesity; Roux-en-Y gastric bypass.