Volume 4, Issue 4, Pages (April 2019)

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Volume 4, Issue 4, Pages 172-175 (April 2019) Duodenal endoscopic submucosal dissection and sutured defect closure across a lumen-apposing metal stent Phillip S. Ge, MD, Hiroyuki Aihara, MD, PhD, Christopher C. Thompson, MD, MHES, Marvin Ryou, MD VideoGIE Volume 4, Issue 4, Pages 172-175 (April 2019) DOI: 10.1016/j.vgie.2018.08.001 Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Creation and reversal of gastric access temporary for endoscopy (GATE). A, EUS-guided puncture of the remnant stomach from Roux limb. B, Injection of contrast material into the remnant stomach. C, Creation of jejunogastric GATE with deployment of lumen-apposing metal stent (LAMS). D, Removal of LAMS after successful trans-GATE endoscopic procedure. E, Prior access site 2 weeks after GATE reversal. F, Injection of contrast material showing no persistent jejunogastric fistula. VideoGIE 2019 4, 172-175DOI: (10.1016/j.vgie.2018.08.001) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Transgastric access temporary for endoscopy (GATE) endoscopic submucosal dissection (ESD) and sutured defect closure. A, Lumen-apposing metal stent 2 weeks after GATE creation. B, Large polyp in the duodenal bulb. C, ESD of the duodenal bulb. D, Resection defect after successful duodenal ESD. E, Sutured closure of the resection defect. F, Injection of contrast material showing no extravasation after sutured defect closure. VideoGIE 2019 4, 172-175DOI: (10.1016/j.vgie.2018.08.001) Copyright © 2018 American Society for Gastrointestinal Endoscopy Terms and Conditions