Utility of Double Balloon Endoscopy for the Diagnosis and Treatment of Stomach and Small Intestine Disorders in Patients with Gastric Bypass

The double balloon endoscope was initially devised for the endoscopic evaluation of small bowel diseases. However, the indications of its use have increased for patients with altered gastrointestinal anatomy after surgery because of its controlled capacity to reach the bypassed organs. One of these situations includes patients with Roux-en-Y gastric bypass, one of the most common surgical techniques performed for morbid obesity. In such patients, the bypassed stomach is inaccessible by conventional upper endoscopy, and the endoscopic and pathological changes of the bypassed stomach are unknown in a long-term period. Aside from common therapeutic procedures like hemostasis and polypectomy, the development of the endoscopic accessories allows the performance of other procedures, such as percutaneous endoscopic gastrostomy and endoscopic retrograde cholangiopancreatography, in such patients.