Endoscopic diathermy incision in the treatment of stoma obstruction after gastroplasty for obesity.

The incidence of stomal obstruction following gastric restrictive procedures varies with the different methods in use. This complication may cause prolonged hospitalization and even reoperation. The objective of this clinical study was to develop a safe and efficient non-operative alternative for treating stomal obstruction. We transferred current techniques and experience from endoscopic papillotomy to the field of bariatric surgery, and during the past four years we have performed fourteen endoscopic diathermy incisions in eleven patients with resistant stoma obstruction after gastroplasty. The results have been good and there have been no complications. Neither has failure to lose weight due to widening of the stoma occurred. Since we took up the procedure, there have been no relaparotomies due to stoma obstruction in our department. In conclusion, endoscopic incision of an obstructed stoma after gastroplasty is an easily-performed and highly effective alternative to other non-operative procedures for the treatment of serious complications in bariatric surgery.