A novel over-the-scope deployment method for enteral stent placement

Area of Science:

• Gastroenterology
• Endoscopic Surgery
• Medical Device Innovation

Background:

• Self-expanding enteral stents are valuable for gastrointestinal (GI) tract issues like strictures and perforations.
• Current delivery systems face limitations in navigating tortuous GI anatomy and meeting size requirements for deployment.

Observation:

• A patient with a colonic perforation secondary to an old anastomosis site presented with abdominal pain and pneumoperitoneum.
• Initial exploration failed to locate the perforation, and a subsequent abscess required percutaneous drainage, yielding stool.
• Barium enema confirmed a descending colon perforation at the anastomosis site.

Findings:

• A novel over-the-scope (OTS) stent deployment method was developed using a heat-activated polymer sheath affixed to the endoscope.
• A fully covered self-expanding metal stent was successfully deployed via the OTS method to cover the colonic perforation.
• Post-deployment evaluation confirmed stent integrity and absence of leakage, with the patient showing stable condition.

Implications:

• This innovative OTS stent placement technique enables the use of various enteral stents in previously inaccessible GI locations.
• The method enhances endoscopic capabilities for treating complex GI perforations and other conditions.
• It offers a promising alternative for patients with challenging anatomy or when conventional delivery systems fail.