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Endoscopic gastrointestinal anastomosis: a review of established techniques

Journal

GASTROINTESTINAL ENDOSCOPY
Volume 93, Issue 1, Pages 34-46

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.gie.2020.06.057

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Advancements in therapeutic endoscopy have led to minimally invasive techniques for GI anastomosis, bypassing obstructions and providing access to the pancreatobiliary tree. These techniques are less invasive, cost-effective, and result in improved outcomes, making them more appealing to patients and providers. Through continued innovation, endoscopic interventions will become a key therapeutic tool for patients requiring GI anastomosis.
Technologic advancements in the field of therapeutic endoscopy have led to the development of minimally invasive techniques to create GI anastomosis without requiring surgery. Examples of the potential clinical applications include bypassing malignant and benign gastric outlet obstruction, providing access to the pancreatobiliary tree in those who have undergone Roux-en-Y gastric bypass, and relieving pancreatobiliary symptoms in afferent loop syndrome. Endoscopic GI anastomosis is less invasive and less expensive than surgical approaches, result in improved outcomes, and therefore are more appealing to patients and providers. The aim of this review is to present the evolution of luminal endoscopic gastroenteric and enteroenteric anastomosis dating back to the first compression devices and to describe the clinical techniques being used today, such as magnets, natural orifice transluminal endoscopic surgery, and EUS-guided techniques. Through continued innovation, endoscopic interventions will rise to the forefront of the therapeutic arsenal available for patients requiring GI anastomosis.

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