Novel technique for over-the-scope stent

Almaskeen_headshotSami Almaskeen, MD, from the Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA shares this VideoGIE case “Over-the-scope stent: a novel technique for stent elongation and deployment.”

Migration of a fully covered self-expandable metal stent (SEMS) interferes with its effectiveness in closing GI leaks. We report a case of gastric leak that failed endoscopic therapy with conventional stenting, with and without anchoring, due to stent migration. A long, over-the-scope stent (OTSS) using a novel technique was then used resulting in tissue healing.

The video demonstrates a new technique for creating and placing a custom length stent, longer than ones commercially available to overcome problems with stent dislodgment in the treatment of gastrointestinal leaks.

This novel technique is easy to perform and might actually reduce expenses and patient suffering by minimizing repeated procedures and replacement of stents.

Find more VideoGIE cases online.

The information presented in Endoscopedia reflects the opinions of the authors and does not represent the position of the American Society for Gastrointestinal Endoscopy (ASGE). ASGE expressly disclaims any warranties or guarantees, expressed or implied, and is not liable for damages of any kind in connection with the material, information, or procedures set forth.

5 thoughts on “Novel technique for over-the-scope stent

    1. Sami Almaskeen

      If I understand the question right, you are asking whether this technique works for Crohn’s disease? This technique was primarily used for closure of perforations and leaks related to postoperative upper GI leaks, spontaneous (i.e. Bhoerhaave syndrome) and iatrogenic perforations when other modalities failed. In these situations the tissue is relatively healthy and amenable to healing. However, in Crohn’s disease, fistulas are usually related to disease activity and inflammation. Therefore, controlling inflammation is key in treatment. For that reason, this technique was not used in IBD patients as the pathology and disease process are different.

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