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First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study

We conducted a pilot study of a potential endoscopic alternative to bariatric surgery. We developed a Natural Orifice Transluminal Endoscopic Surgery (NOTES) gastric bypass with controlled bypass limb length using four new devices including a dedicated lumen-apposing metal stent (GJ-LAMS) and pylori...

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Autores principales: Gonzalez, Jean-Michel, Ouazzani, Sohaib, Monino, Laurent, Beyer-Berjot, Laura, Berdah, Stephane, Cauche, Nicolas, Delattre, Cecilia, Peetermans, Joyce A., Dayton, Peter, Gjata, Ornela, Curran, Darren, Barthet, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741923/
https://www.ncbi.nlm.nih.gov/pubmed/34996894
http://dx.doi.org/10.1038/s41598-021-02921-9
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author Gonzalez, Jean-Michel
Ouazzani, Sohaib
Monino, Laurent
Beyer-Berjot, Laura
Berdah, Stephane
Cauche, Nicolas
Delattre, Cecilia
Peetermans, Joyce A.
Dayton, Peter
Gjata, Ornela
Curran, Darren
Barthet, Marc
author_facet Gonzalez, Jean-Michel
Ouazzani, Sohaib
Monino, Laurent
Beyer-Berjot, Laura
Berdah, Stephane
Cauche, Nicolas
Delattre, Cecilia
Peetermans, Joyce A.
Dayton, Peter
Gjata, Ornela
Curran, Darren
Barthet, Marc
author_sort Gonzalez, Jean-Michel
collection PubMed
description We conducted a pilot study of a potential endoscopic alternative to bariatric surgery. We developed a Natural Orifice Transluminal Endoscopic Surgery (NOTES) gastric bypass with controlled bypass limb length using four new devices including a dedicated lumen-apposing metal stent (GJ-LAMS) and pyloric duodenal exclusion device (DED). We evaluated procedural technical success, weight change from baseline, and adverse events in growing Landrace/Large-White pigs through 38 weeks after GJ-LAMS placement. Six pigs (age 2.5 months, mean baseline weight 26.1 ± 2.7 kg) had initial GJ-LAMS placement with controlled bypass limb length, followed by DED placement at 2 weeks. Technical success was 100%. GJ-LAMS migrated in 3 of 6, and DED migrated in 3 of 5 surviving pigs after mucosal abrasion. One pig died by Day 94. At 38 weeks, necropsy showed 100–240 cm limb length except for one at 760 cm. Weight gain was significantly lower in the pigs that underwent endoscopic bypass procedures compared to expected weight for age. This first survival study of a fully endoscopic controlled bypass length gastrojejunostomy with duodenal exclusion in a growing porcine model showed high technical success but significant adverse events. Future studies will include procedural and device optimizations and comparison to a control group.
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spelling pubmed-87419232022-01-10 First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study Gonzalez, Jean-Michel Ouazzani, Sohaib Monino, Laurent Beyer-Berjot, Laura Berdah, Stephane Cauche, Nicolas Delattre, Cecilia Peetermans, Joyce A. Dayton, Peter Gjata, Ornela Curran, Darren Barthet, Marc Sci Rep Article We conducted a pilot study of a potential endoscopic alternative to bariatric surgery. We developed a Natural Orifice Transluminal Endoscopic Surgery (NOTES) gastric bypass with controlled bypass limb length using four new devices including a dedicated lumen-apposing metal stent (GJ-LAMS) and pyloric duodenal exclusion device (DED). We evaluated procedural technical success, weight change from baseline, and adverse events in growing Landrace/Large-White pigs through 38 weeks after GJ-LAMS placement. Six pigs (age 2.5 months, mean baseline weight 26.1 ± 2.7 kg) had initial GJ-LAMS placement with controlled bypass limb length, followed by DED placement at 2 weeks. Technical success was 100%. GJ-LAMS migrated in 3 of 6, and DED migrated in 3 of 5 surviving pigs after mucosal abrasion. One pig died by Day 94. At 38 weeks, necropsy showed 100–240 cm limb length except for one at 760 cm. Weight gain was significantly lower in the pigs that underwent endoscopic bypass procedures compared to expected weight for age. This first survival study of a fully endoscopic controlled bypass length gastrojejunostomy with duodenal exclusion in a growing porcine model showed high technical success but significant adverse events. Future studies will include procedural and device optimizations and comparison to a control group. Nature Publishing Group UK 2022-01-07 /pmc/articles/PMC8741923/ /pubmed/34996894 http://dx.doi.org/10.1038/s41598-021-02921-9 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Gonzalez, Jean-Michel
Ouazzani, Sohaib
Monino, Laurent
Beyer-Berjot, Laura
Berdah, Stephane
Cauche, Nicolas
Delattre, Cecilia
Peetermans, Joyce A.
Dayton, Peter
Gjata, Ornela
Curran, Darren
Barthet, Marc
First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title_full First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title_fullStr First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title_full_unstemmed First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title_short First fully endoscopic metabolic procedure with NOTES gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
title_sort first fully endoscopic metabolic procedure with notes gastrojejunostomy, controlled bypass length and duodenal exclusion: a 9-month porcine study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8741923/
https://www.ncbi.nlm.nih.gov/pubmed/34996894
http://dx.doi.org/10.1038/s41598-021-02921-9
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