Abstract
Leaks and fistulas are serious complications following gastrointestinal surgeries, traditionally managed by self-expandable metal stents and endoscopic vacuum therapy. The stent-over-sponge (SOS) technique is a new modality used as a rescue option when other interventions fail. This report presents the case of a 60-year-old female patient who underwent revisional bariatric surgery and developed a leak post-operation. Initial management included endoscopic debridement and the placement of an Endo-VAC system. Due to technical difficulties, the sponge was left in an endoluminal position, leading to migration. A partially covered stent was placed to prevent further migration and facilitate healing. The patient experienced complications, including hematemesis, but ultimately achieved complete leak closure and is asymptomatic six months post-treatment. In this case, the SOS technique demonstrates its safety and efficacy in dealing with post-operative leaks in patients having undergone bariatric surgery, which would justify performing more extended evaluative studies.