Post written by Mitsuru Okuno, MD, PhD, from the Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan.

EUS-guided drainage of walled-off necrosis (WON) is the accepted efficient and safe standard of care. The LAMS has a large lumen (up to 10 mm) and dual flanges that tightly adhere the LAMS to the fistula within the WON cavity and gastric lumen. However, when the LAMS accidentally migrated to the gastric lumen during necrosectomy procedure, its replacement appeared difficult due to the large lumen and flanges. We successfully replaced the migrated LAMS during the same necrosectomy session and introduce this technique with video. This technique can be performed rapidly and easily during endoscopic necrosectomy.

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