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Diagrammatic representation of the laparoscopic endoscopy in our patient who had had Roux-en-Y gastric bypass for morbid obesity. The endoscope was introduced into the abdomen through a laparoscopic port and then into the diverted stomach through a gastrostomy incision.
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The gastroscope was introduced through the 15-mm trocar in the left upper quadrant and guided into the residual stomach via the already made gastrostomy (Figure 1).
Intraoperative picture via the gastroscope showing the duodenal ulcer.
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There was also a fresh duodenal ulcer with a clot over the base (Figure 2).