A New Technique for Direct Percutaneous Endoscopic Jejunostomy Using Double Balloon Endoscopy and Magnetic Anchors in a Porcine Model

New method of direct percutaneous endoscopic jejunostomy tube placement using balloon‐assisted enteroscopy with fluoroscopy

“…In an animal model, Yano et al . demonstrated the concept of overtube‐assisted DPEJ . We believe that the principles and concepts described in the animal model by Yano et al .…”

“…Nevertheless, fluoroscopy should improve safety of tube placement and confidence of the endoscopist and should be an option at a tertiary referral center. Experimental data in the live pig model also showed that magnetic fasteners are a solution to safely attach the loop of the jejunum to the parietal peritoneum before DPEJ access is attempted . Finally, in our technique, the DPEJ travels inside the overtube, thus minimizing the chances of laceration or perforation of the luminal GI tract, especially in angled curves, the duodenal sweep, adhesions, anastomosis and stenosis.…”

“…In a nicely designed animal model endoscopic experiment, Yano et al . described the process of safe DPEJ using overtube, balloons and magnetic anchors . Our approach is based on this novel concept and focuses on three key components: (i) use of balloon‐assisted overtube; (ii) use of fluoroscopy; and (iii) leaving the overtube in place during the entire procedure (and also for DPEJ removal).…”

Endoscopic solutions to challenging enteral feeding problems

“…Nine out of 10 attempts were successful and there were no complications. Refinement of DBE PEJ placement is currently being studied in porcine models, with the emphasis on improving jejunal stabilization with magnetic anchors [9]. Similar successful PEJ placement rates were also noted in a 12-case series using SBE [10].…”