EUS-assisted, fluoroscopically guided gastrostomy tube placement in patients with Roux-en-Y gastric bypass: a novel technique for access to the gastric remnant.

Access to the excluded gastric remnant in patients after Roux-en-Y gastric bypass for gastrostomy tube placement or therapeutic endoscopy is a technical challenge. Available techniques include interventional radiology-placed gastrostomy, deep enteroscopy, and surgical gastrostomy; however, these techniques are hampered by complications, technical complexity, or invasiveness.