Endoscopy in surgically altered anatomy

As technology develops, the utilization of endoscopy in the diagnosis and treatment of gastrointestinal disorders continues to expand. While the majority of these procedures occur in patients with native anatomy, the cohort of patients with altered gastrointestinal anatomy continues to rise. A solid understanding of the variations and implications of surgically-altered anatomy is paramount to effectively performing endoscopy in postsurgical patients. Additionally, the ability to distinguish normal from abnormal findings is essential to identifying and reporting problems. This article will describe common postsurgical anatomy that the endoscopist is likely to encounter. We discuss normal and abnormal findings and suggest techniques for obtaining accurate diagnostic information. Additionally, we highlight the essential components of the endoscopic evaluation and discuss how to communicate that information to the requesting provider to help direct patient care.