Helpful technical notes for intraperitoneal natural orifice transluminal endoscopic surgery (NOTES) salvage in a failed EUS-guided gastroenterostomy scenario

The main reasons for dislodgement of the distal flange of a lumen-apposing metal stent (LAMS) into the peritoneum during endoscopic ultrasound (EUS)-guided gastroenterostomy are that the delivery catheter pushes away the small bowel without entering it, or else that advancement of a preloaded guidewire tents away the jejunal loop (in both cases, the EUS window is...