Secured Lumen-Apposing Fully Covered Metallic Stents for Stenoses in Post-Bariatric Surgery Patients.


Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institutions, 1800 Orleans Street, Sheikh Zayed Tower, 7th floor, Suite 7125B, Baltimore, MD, 21287, USA. [Email]


New approaches for refractory stenosis in post-bariatric surgical patients include fully covered lumen-apposing metallic stents (LAMS); however, stent migration continues to be a problem. Endoscopic suture placement to LAMS can reduce the migration. Aiming to assess the feasibility and safety of the procedure, we evaluated nine consecutive patients with inability to tolerate a solid diet due to a benign gastrointestinal stricture recalcitrant to previous attempts at endoscopic therapy. All patients were symptom-free starting from 1-week follow-up. Median stent dwell time was nearly 3 months. During the removal procedures, three incidental foreign bodies were found and removed. No stent migration was observed in any patients. Suturing LAMS is a feasible technique allowing for prolonged stent dwell times; however, it requires a high level of expertise plus additional procedure time.


Bariatric surgery,Lumen-apposing metallic stent,Obesity,Self-expandable metallic stents,Stricture,