Alternative uses of lumen apposing metal stents

Figure 4 The lumen of the stent is dilated up to the diameter of the stent lumen, thereby allowing for easy passage of any wider endoscope to access the remnant stomach to complete the desired procedure. A: Normal Roux-en-Y gastric bypass (RYGB) anatomy showing long endoscopic route to be traversed to access the biliary system; B: Lumen apposing metal stent (LAMS) placement between gastric pouch and remnant stomach in RYGB anatomy; C: LAMS placement between blind limb and remnant stomach in RYGB anatomy; D: LAMS placement between Roux Limb and remnant stomach in RYGB anatomy. LAMS: Lumen apposing metal stent.