Surgical reversal of Roux-en-Y gastric bypass is associated with significant morbidity. Endoscopic ultrasound (EUS)-guided creation of gastro-gastric (GG) fistulas, using lumen apposing metal stents (LAMS) offers a minimally invasive alternative, but the inability to leave stents in long-term and fistula closure soon after stent removal limits durability.
Consecutive patients underwent parallel-LAMS septotomy for partial reversal of the RYGB between 2023 and 2025 at two tertiary centers. Technical and clinical outcomes were assessed.
Six patients (mean age 64.5 years), mean BMI of 21.9 ± 3.9 kg/m2 underwent parallel-LAMS septotomy. Technical and clinical success was achieved in all 6 patients (100%). All anastomoses were durable on median follow-up of 24 weeks (range 16-50). There were no major adverse events.
Parallel-LAMS septotomy provides a safe and effective endoscopic approach to achieve a durable GG anastomosis, thereby partially reversing RYGB without reliance on in-dwelling stents.
- Durable Partial Reversal of Roux-en-Y Gastric Bypass Using the Parallel-Lumen Apposing Metal Stent Septotomy Technique: A Multicenter Feasibility Study
- Kambiz Kadkhodayan - AdventHealth OrlandoKhaled Almujarkesh - AdventHealth OrlandoSaurabh Chandan - AdventHealth OrlandoSagar J. Pathak - AdventHealth OrlandoGustavo Bellovincentelli - AdventHealth OrlandoAbdullah Abassi - AdventHealth OrlandoArtur Viana - AdventHealth OrlandoNatalie Cosgrove - AdventHealth OrlandoMaham Hayat - AdventHealth OrlandoDeepanshu Jain - AdventHealth OrlandoDennis Yang - AdventHealth OrlandoPeter Peng - AdventHealth OrlandoMuhammad Hasan - AdventHealth OrlandoShayan S. Irani - Virginia Mason Medical Center
- Gastrointestinal endoscopy
- Elsevier Inc
- 991006257589502656
- Gastroenterology; Internal Medicine
- English
- Journal article