A through-the-scope device for suturing and tissue approximation under EUS control

Prospective evaluation of endoscopic ultrasonography-guided double-balloon-occluded gastrojejunostomy bypass (EPASS) for malignant gastric outlet obstruction

“…Moreover, even if the puncture is successfully performed, following several steps such as guidewire advancement in the deeper jejunum, tract dilation and stent delivery system insertion is not easy because the collapsed jejunum can move away from the stomach. Thus, to date, there have only been two major techniques for EUS-GJ, namely, water-filling technique2 5 and water-inflated balloon technique 5. For the water-inflated balloon technique, although needle puncture to the inflated balloon (approximately 2 cm) appears easy to perform in the jejunum, following the procedure, however, seems to be difficult unless lumen-apposing devices such as a tilt-tag or an anchor wire are used ideally for securing the jejunum to the stomach wall and bringing together the two non-adherent organs.…”

Current status and perspective of endoscopic ultrasonography‐guided gastrojejunostomy: endoscopic ultrasonography‐guided double‐balloon‐occluded gastrojejunostomy (with videos)

“…Although successful EUS-guided gastrojejunostomy has been reported in pigs [21][22][23], there are several hurdles in accomplishing this procedure in the human clinical setting as follows: (1) difficulty of transgastric puncture into the collapsed jejunum using a 19-gauge FNA needle without any preparation; (2) no standard devices for lumen-apposing of the stomach and jejunum throughout the procedure; and (3) no dedicated tool for the creation of anastomosis of nonadherent lumens.…”

“…Since then, several investigators reported on gastrojejunostomy using flexible forward-view endoscopy in mainly animal studies and a few clinical studies using flared-type metal stents, magnets or natural orifice transluminal endoscopic surgery [14][15][16][17][18][19][20]. In 2002, Fritscher-Ravens et al reported on EUS-guided gastrojejunostomy in pigs using a special compression button [21,22]. In 2012, Binmoeller and Shah [23] introduced the lumen-apposing metal stent, which can be attached between the gastric and jejunal walls as an ideal device for EUS-guided gastrojejunostomy in a pig model.…”

Endoscopic treatment for gastric perforation using T-tag and a plastic protection chamber: a short-term survival study

“…Beside the use of clips, many endoscopic methods with this aim are in development (1,2,4,5,6,10) . Most devices proposed use stitches to make a suture in the gastrointestinal tract wall.…”

“…Experimental studies in gastrointestinal perforation repair showed that this event is not so rare when the perforation is performed with T-tag (1,2,4,5,6,7,10,12,13) . The idea of using a chamber to protect other abdominal organs seems to be very important when the closure is performed with T-tag (3,11,12) .…”