Complication-chronic Sleeve Leak and Retained Stent

Background: Sleeve gastrectomy is emerging as a popular option in bariatric surgery. Sleeve leak is a known complication of this procedure and many propose the use of endoluminal stents in the management of sleeve leaks. Stents also carry their own set of risks and complications. Methods: This is a case of a patient who underwent a sleeve gastrectomy and developed a postoperative leak. An attempted to manage this leak with endoluminal stenting was unsuccessful and the patient developed a chronic fistula. In addition, the stents that were placed could not be retrieved due to dense mucosal in-growth. Results: This video presentation shows a combination of a laparoscopic and endoscopic approach in treating this particular patient with a chronic leak and retained stents. Conclusion: Covered stents can be used in treating sleeve leaks, however, they also have risks and complications. Mucosal in-growth is a complication of stents and may make stent retrieval a challenge. The combined laparoscopic and endoscopic approach of stent retrieval is one method in approaching this difficult problem.