Volume 2, Issue 12, Pages (December 2017)

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Volume 2, Issue 12, Pages 346-348 (December 2017) Natural orifice transluminal endoscopic surgery salvage of direct EUS-guided gastrojejunostomy Ramon Sanchez-Ocana, MD, Irene Penas-Herrero, MD, Paula Gil-Simon, MD, Carlos de la Serna-Higuera, MD, Manuel Perez-Miranda, MD, PhD VideoGIE Volume 2, Issue 12, Pages 346-348 (December 2017) DOI: 10.1016/j.vgie.2017.08.004 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 EUS-guided enteroclysis before insertion of lumen-apposing metal stent. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Distal flange of lumen-apposing metal stent after inadvertent intraperitoneal deployment. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Small-bowel suction into transgastric lumen-apposing metal stent before needle-knife incision. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 4 Traction of second LAMS delivery catheter with distal flange deployed inside small bowel (arrowhead) into transgastric LAMS (arrow) to perform LAMS in LAMS. LAMS, lumen-apposing metal stent. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 5 Fluoroscopic view of second LAMS fully deployed within initially misplaced LAMS. Contrast material flushed through the gastroscope remains within the small bowel with no leakage. LAMS, lumen-apposing metal stent. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 6 Endoscopic view after deployment of second lumen-apposing metal stent, showing jejunal lumen and 2 metal stent meshes, 1 inside the other. VideoGIE 2017 2, 346-348DOI: (10.1016/j.vgie.2017.08.004) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions