Feasibility of Conversion of a New Bariatric Fully Endoscopic Bypass Procedure to Bariatric Surgery: a Porcine Pilot Study

Gonzalez, Jean‐Michel; Duconseil, Pauline; Ouazzani, Sohaib; Berdah, Stéphane; Cauche, Nicolas; Delattre, Cécilia; Peetermans, Joyce; Gjata, Ornela; Santoro-Schulte, Agostina; Barthet, Marc

doi:10.1007/s11695-022-06065-1

Cited by 3 publications

(6 citation statements)

References 20 publications

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“…This procedure uses short-term placement of a gastrojejunal lumen-apposing metal stent (GJ-LAMS) to create a gastrojejunal anastomosis (GJA) with a controlled bypass length and a dedicated duodenal exclusion device (DED) to induce weight loss. Our studies to date suggest that the baseline endoscopic procedure 5 and conversion to a one-anastomosis duodenal-jejunal bypass 6 may be feasible in juvenile pigs. A similar animal study published in 2021 used endoscopic sleeve gastroplasty for gastric volume reduction followed by a GJA and pyloric closure, without dedicated devices or postprocedural longitudinal follow-up 7 .…”

Section: Introductionmentioning

confidence: 89%

“…Animal handling, preprocedural care and anesthesia were handled as reported previously 5 , 6 . The study was reported in accordance with the ARRIVE guidelines 8 .…”

Section: Methodsmentioning

confidence: 99%

“…The DED underwent modifications since our previous studies 5 , 6 . The current design was modified to an asymmetric dumbbell to enhance pullout force while maintaining tissue contact with uncoated regions.…”

Section: Methodsmentioning

confidence: 99%

“…DED uncoated regions and EMR were used to promote tissue ingrowth for decreasing the migration rate. The GJ-LAMS device was the same design as in previous studies 5 , 6 .…”

Section: Methodsmentioning

confidence: 99%

“…Since 2020, our research team has tested a natural orifice transluminal endoscopic surgery (NOTES) gastrojejunostomy in animal studies as a potential alternative 4 , 5 or bridge 6 to bariatric surgery. This procedure uses short-term placement of a gastrojejunal lumen-apposing metal stent (GJ-LAMS) to create a gastrojejunal anastomosis (GJA) with a controlled bypass length and a dedicated duodenal exclusion device (DED) to induce weight loss.…”

Section: Introductionmentioning

confidence: 99%

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Feasibility of a new bariatric fully endoscopic duodenal-jejunal bypass: a pilot study in adult obese pigs

Gonzalez

Ouazzani

Berdah

et al. 2022

Sci Rep

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This study assessed a new natural orifice transluminal endoscopic surgery (NOTES) bariatric endoscopic procedure in obese adult pigs. This 14-week prospective study compared 6 adult male Yucatan test pigs with baseline mean age 1.5 years to 2 control pigs. The test pigs received a fully endoscopic NOTES-based duodenal-jejunal bypass including measurement of the bypassed limb and creation of a gastrojejunal anastomosis (GJA) using a gastrojejunal lumen-apposing metal stent (GJ-LAMS) at Week 0, placement of a duodenal exclusion device (DED) at Week 2, and endoscopic examinations at Weeks 6 and 10. At Week 14, the pigs were sacrificed for necropsy. All endoscopic procedures were technically successful. By Week 14, the controls had gained a mean 1.1 ± 2.1 kg (+ 1.6%) while the intervention animals lost a mean 6.8 ± 3.9 kg (− 10.5%) since baseline. GJ-LAMS migrations occurred in 3 pigs, two of which also had DED migration and/or partial dislocation. Two other pigs died, one with aberrant splenic vein positioning near the GJA and the other from an unknown cause. An endoscopic bariatric bypass procedure with controlled bypass length was technically successful in all the cases and led to weight loss in test animals. Safety concerns must be further addressed.

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Section: Introductionmentioning

confidence: 89%

“…Animal handling, preprocedural care and anesthesia were handled as reported previously 5 , 6 . The study was reported in accordance with the ARRIVE guidelines 8 .…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…DED uncoated regions and EMR were used to promote tissue ingrowth for decreasing the migration rate. The GJ-LAMS device was the same design as in previous studies 5 , 6 .…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Feasibility of a new bariatric fully endoscopic duodenal-jejunal bypass: a pilot study in adult obese pigs

Gonzalez

Ouazzani

Berdah

et al. 2022

Sci Rep

Self Cite

View full text Add to dashboard Cite

show abstract

Feasibility of a fully endoscopic one-anastomosis gastric bypass procedure after endoscopic sleeve gastroplasty in pigs

Ouazzani,

Gonzalez,

Leclercq

et al. 2024

iGIE

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Current uses of electro-cautery lumen apposing metal stents in endoscopic ultrasound guided interventions

Liu

et al. 2022

Front. Med.

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The electro-cautery lumen apposing metal stent (EC-LAMS) is a newly developed device that integrates the electro-cautery cyctotome with the one-step metal stent delivery and releasing system in recent years. LAMS was first designed to complete the drainage of pancreatic fluid collection under endoscopic ultrasound guidance, and the technological innovation of EC-LAMS has made more off-labeled indications of endoscopic intervention for gastrointestinal diseases realized, such as abdominal fluid drainage, bile duct, or gallbladder drainage through stomach or duodenum, gastrointestinal anastomosis, and the establishment of fistulous channel for further endoscopic operation when necessary. The unique feature of this metal stent is that it has the design of a saddle shape and a large lumen, and can almost connect the adjacent structures to minimize the risk of perforation and leakage. Compared with traditional LAMS, EC-LAMS, an advanced integrated device, can greatly simplify the endoscopic process, shorten the procedure time and reduce the technical difficulty, thus it can help endoscopists complete more complex endoscopic interventions. In this review, we discuss the state of art with regard to EC-LAMS and its endoscopic process, current indications, outcomes, adverse events, and future application prospects.

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Feasibility of Conversion of a New Bariatric Fully Endoscopic Bypass Procedure to Bariatric Surgery: a Porcine Pilot Study

Cited by 3 publications

References 20 publications

Feasibility of a new bariatric fully endoscopic duodenal-jejunal bypass: a pilot study in adult obese pigs

Feasibility of a new bariatric fully endoscopic duodenal-jejunal bypass: a pilot study in adult obese pigs

Feasibility of a fully endoscopic one-anastomosis gastric bypass procedure after endoscopic sleeve gastroplasty in pigs

Current uses of electro-cautery lumen apposing metal stents in endoscopic ultrasound guided interventions

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