ASGE DDW Videos from Around the World | 2025-TIPS AND TRICKS WHEN AN EDGE FAILS CHALLENGE OF SEVERE LOOPING IN A LARGE GASTRIC POUCH AND HIATAL HERNIA

TIPS AND TRICKS WHEN AN EDGE FAILS CHALLENGE OF SEVERE LOOPING IN A LARGE GASTRIC POUCH AND HIATAL HERNIA

Video Transcription

Video Summary

The transcript provides tips and solutions for when endoscopic gastric outlet reduction (EDGE) procedures experience failures, particularly due to anatomical complexities like large hiatal hernias and gastric pouches. Techniques involve careful trajectory planning, using fluoroscopic guidance, and optimizing endoscopic tool use. In challenging cases of gastric pouch looping, recommendations include using large lumens, scope lubrication, and strategic balloon dilation. When initial attempts fail, converting to a two-session approach, removing the luminal stent, and retrying after the fistula matures can be effective. The case discussed underscores the importance of adaptability and strategic planning in such procedures.

Asset Subtitle

Amar Vedamurthy

Meta Tag

Concept EUS-directed Transgastric Intervention

Concept Excluded Stomach

Concept Lumen-Apposing Self-Expanding Metal Stent

Concept Gastric Pouch

Concept Hiatal Hernia

Keywords

endoscopic gastric outlet reduction

hiatal hernias

fluoroscopic guidance

balloon dilation

strategic planning

EUS-directed Transgastric Intervention

Excluded Stomach

Lumen-Apposing Self-Expanding Metal Stent

Gastric Pouch

Hiatal Hernia