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- Title
Feasibility of Conversion of a New Bariatric Fully Endoscopic Bypass Procedure to Bariatric Surgery: a Porcine Pilot Study.
- Authors
Gonzalez, Jean-Michel; Duconseil, Pauline; Ouazzani, Sohaib; Berdah, Stephane; Cauche, Nicolas; Delattre, Cecilia; Peetermans, Joyce A.; Gjata, Ornela; Santoro-Schulte, Agostina; Barthet, Marc
- Abstract
Purpose: Bariatric endoscopic procedures are emerging as alternatives to bariatric surgical procedures. This study aimed to assess if a natural orifice transluminal endoscopic surgery (NOTES) bariatric procedure could be converted to a surgical duodenal-jejunal bypass (DJB) or sleeve gastrectomy (SG). Materials and Methods: This 12-week prospective study compared 4 test pigs to 3 control (no procedures) pigs aged 3 months at baseline. The test pigs received a fully endoscopic NOTES-based bypass including measurement of the bypassed limb and creation of a gastrojejunal anastomosis (GJA) using gastrojejunal lumen-apposing metal stents (GJ-LAMS) at Week 0, placement of a duodenal exclusion device (DED) at Week 2, and randomization to DJB or SG surgery at Week 8 with subsequent 4-week follow-up. At Week 12, the pigs were sacrificed and necropsy was performed. Results: Endoscopic procedures were technically successful. One pig did not receive a DED due to early GJ-LAMS migration leading to premature closure of the GJA. At Week 8, all 4 pigs were doing well, and the remaining 3 GJ-LAMS and 3 DEDs were uneventfully endoscopically removed. Two one-anastomosis DJB were performed, and 2 SG were performed, closing in one case the site of the previous GJA. The surgical procedures were technically feasible and uneventful during follow-up. Necropsy assessments showed no local or peritoneal inflammation or abscess and no leakage or fistula. Conclusion: An endoscopic bariatric bypass can be transitioned to a one-anastomosis duodenal-jejunal bypass or sleeve gastrectomy, without complications.
- Subjects
BARIATRIC surgery; JEJUNOILEAL bypass; ENDOSCOPIC surgery; SLEEVE gastrectomy; GASTRIC bypass; OPERATIVE surgery; PILOT projects
- Publication
Obesity Surgery, 2022, Vol 32, Issue 7, p2280
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-022-06065-1