Endoscopic technologies for the treatment of postoperative complications in bariatric patients

Objective. To demonstrate the experience of successful treatment of patients with staple line leaks using various endoscopic techniques. Material and methods. In the period from December 2023 to January 2024, two patients underwent treatment at the Vishnevsky National Medical Research Center of Surgery: a 46-year-old patient with a body mass index of 51.3 and a 40-year-old patient with a body mass index of 49.3. Both patients developed staple line leaks following laparoscopic sleeve gastrectomy performed for morbid obesity. Results. In the first clinical case, a staple line leak was identified on the 4th postoperative day. Given the persistent leak in the staple line after ultrasound-guided drainage, closure of the defect was performed using an endoscopic over-the-scope clip (OTSC). In the second clinical case, due to the formation of a large cavity measuring 9 cm in diameter, a vacuum-assisted aspiration system was placed. Subsequently, after removal of the vacuum-assisted aspiration system, persistent gastric sleeve wall defect was closed using an endoscopic over-the-scope clip (OTSC). Conclusion. Our study demonstrates the potential of intraluminal endoscopic techniques in the treatment of bariatric patients with staple line leaks. Thus, the endoscopic approach for managing staple line leaks after bariatric interventions represents a modern minimally invasive method and serves as an alternative to surgical interventions, provided that adequate sanitation and drainage of fluid collections in the abdominal cavity are ensured.