Natural orifice transluminal endoscopic surgery gastroenterostomy with a biflanged lumen-apposing stent: first clinical experience (with videos)

Gastrointest Endosc. 2015 Jan;81(1):215-8. doi: 10.1016/j.gie.2014.09.039.

Abstract

Background: We established feasibility and safety for natural orifice transluminal endoscopic surgery (NOTES) GI anastomosis with a lumen-apposing stent in live pigs. This approach was performed in 3 patients.

Objective: Creation of a NOTES gastroduodenal anastomosis in patients.

Design: Case series.

Setting: Two tertiary-care referral centers at large academic hospitals in France and in the United States.

Patients: Patients with refractory benign duodenal stenosis and malignant duodenal obstruction.

Intervention: NOTES GI anastomosis with a lumen-apposing stent.

Main outcome measurements: Disappearence of gastric outlet obstruction.

Results: All 3 procedures were technically successful and uneventful, except 1 minor adverse event. There were no instances of stent occlusion or migration during follow-up. All patients resumed a normal diet.

Limitations: Small case series.

Conclusion: NOTES gastroenteric anastomosis is feasible and safe in humans. A prospective pilot study is warranted.

Publication types

  • Case Reports
  • Video-Audio Media

MeSH terms

  • Adenocarcinoma / complications*
  • Adult
  • Aged
  • Duodenal Obstruction / etiology
  • Duodenal Obstruction / surgery*
  • Endoscopy, Gastrointestinal / methods*
  • Gastric Bypass / methods*
  • Humans
  • Intestinal Atresia
  • Male
  • Natural Orifice Endoscopic Surgery
  • Pancreatic Neoplasms / complications*

Supplementary concepts

  • Familial duodenal atresia