Re: “Laparoscopic Roux-en-Y Gastric Bypass: Surgical Technique and Tips for Success”

Dear Editors:

We have recently read with great interest the article by Schlottmann and Buxhoeveden, entitled “Laparoscopic Roux-en-Y Gastric Bypass: Surgical Technique and Tips for Success,” which was published in the August 2018 issue of the Journal of Laparoendoscopic & Advanced Surgical Techniques. ¹

First of all, we would like to thank the author for his interest in our case report, which was cited in the article. ²

In the “preoperative work-up” section, Schlottmann and Buxhoeveden stated that “The latter (preoperative esophagogastroduodenoscopy) is particularly important because the remnant stomach will no longer be accessible to endoscopic surveillance.”

We simply cannot agree with this statement. Different articles have proven the feasibility of accessing the remnant stomach by device-assisted enteroscopy, as described in a recent overview. ³

As pathology of the excluded stomach after Roux-en-Y gastric bypass is underestimated and often not clinically obvious, we furthermore suggest to keep a low threshold for endoscopic examination of the remnant stomach.