Endoscopic gastrostomy after bariatric surgery: a unique approach.

Gastrostomy tube placement after Roux-en-Y gastric bypass can be challenging, particularly in patients with dense abdominal adhesions. Novel, minimally invasive approaches are needed to access the gastric remnant when needed. We present an innovative method for gastrostomy tube placement in a patient with a retrocolic gastric bypass using a combined endoscopic ultrasound and fluoroscopy-guided approach, describing the essential technical steps of the procedure.