Management of secondary fistulas following bariatric surgery using endoscopic vacuum-assisted closure

Obesity significantly impacts individuals' quality of life. Bariatric surgery, including vertical sleeve gastrectomy and gastric bypass, is effective for long-term weight loss but has increased post-bariatric complications like fistulas. We treated three patients with post-bariatric complications. Cases included a gastropleural fistula secondary to vertical sleeve gastrectomy and an esophagojejunal fistula secondary to Roux-en-Y gastric bypass. Endoscopic vacuum-assisted closure (EVAC) was used, applying continuous negative pressure via a polyurethane sponge connected to suction. The EVAC technique effectively managed complex post-bariatric fistulas, facilitating closure and improving outcomes. Patient selection and technical expertise are crucial for optimizing EVAC results. This innovative approach offers a promising solution for post-bariatric complications, enhancing recovery and quality of life.