Related Experiment Video
Updated: May 12, 2026
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Durable partial reversal of Roux-en-Y gastric bypass using the parallel lumen-apposing metal stent septotomy
Kambiz Kadkhodayan1, Khaled Almujarkesh1, Saurabh Chandan1
1Center for Interventional Endoscopy, AdventHealth Orlando, Orlando, Florida, USA.
Background And Aims:
Surgical reversal of Roux-en-Y gastric bypass (RYGB) is associated with significant morbidity. EUS-guided creation of gastrogastric (GG) fistulas, using lumen-apposing metal stents (LAMSs), offers a minimally invasive alternative, but the inability to leave stents in place long term and fistula closure soon after stent removal limit durability.
Methods:
Consecutive patients underwent parallel LAMS septotomy for partial reversal of the RYGB between 2023 and 2025 at 2 tertiary centers. Technical and clinical outcomes were assessed.
Results:
Six patients (mean age, 64.5 years) with a mean body mass index of 21.9 ± 3.9 kg/m2 underwent parallel LAMS septotomy. Technical and clinical success was achieved in all 6 patients (100%). All anastomoses were durable at a median follow-up of 24 weeks (range, 16-50). There were no major adverse events.
Conclusions:
Parallel LAMS septotomy provides a safe and effective endoscopic approach to achieve a durable GG anastomosis, thereby partially reversing RYGB without reliance on indwelling stents.
