Pilot Data on the Endoscopic Placement of Covered Metal Stents to Treat Gastrojejunal Leaks in a Porcine Model

Abstract

Placement of fully covered metal stents is feasible. The use of small pigs with a thin small bowel wall in combination with relatively large stents was most likely the reason for complications found in all stented animals. Further studies of GJ leaks using these stents will require larger pigs or a different species.

Gastrojejunal anastomosis using a tissue-apposing stent: a safety and feasibility study in live pigs

“…The topic of anastomotic suture is one of the main focuses and challenges for NOTES research [12]. Despite new instruments and multitasking platforms for suturing and creating an anastomosis, their clinical use is very limited and effective endoscopic suturing devices are still required [13]. Several methods have been described to obtain a permanent GJA using a transgastric approach and NOTES.…”

“…Strong benefits of the stent apposition method in the current series were the security of the procedure (avoidance of leakage due to the AXIOS stent being fully covered and exerting a significant radial force) and the reproducibility of the technique, without any migration or impaction of the stent. This concept was initially proposed by Sporn et al [13], who prevented postsurgical GJA leak by placement of a fully covered metallic stent in a porcine model. A partially covered occluder was previously used by Luo et al [16] to perform experimental NOTES gastroenterostomy in a canine model.…”