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Obesity

Gastric bypass surgery for morbid obesity.
A endoscopic view showing partial dehiscence of the suture line in a patient who five years earlier had undergone a vertical banded gastroplasty for morbid obesity. After initial success and considerable loss of weight, the patient had recently started to regain weight.

The endoscopy shows that the suture line has partially dehisced. The 'normal' orifice is to the right of the picture. The diameter of this lumen was determined at initial surgery by stapling closed the fundus of the stomach to form a (25-50 ml) pouch and bringing the staple margin to within about 12 mm of the lesser curve. This stoma is then wrapped in nylon mesh to prevent dilatation. The mesh can be seen around the stoma.

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