LAMS have the right shape for select strictures (pyloric, etc). Backload a LAMS stent for easier deployment across an enteral stricture Line it up, fold it, pull into channel Locate stricture and use “push” to deploy. #GITwitter #Endoscopy #MedEd #SoMe4Surgery #medicine

@RashidLui @AdvaniRashmiMD @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls Beautiful demonstration. I use this technique for DEN if LAMS removal is needed for more swift necrosectomy and replace same LAMS back

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls The only issue with this technique is the difficulty in releasing the teeth of the biopsy forceps from stent mesh which can result in stent displacement. Why not to use the original assembly of Axios to deploy the stent or use Spaxus stent (half cost, same result)!?

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls Good ?s 😊 No spaxus here in the USA Have done both ways for enteral: Original & as above As for issues w displacement from forceps ..done many, many - hasn’t happened (as yet) The forceps is at the distal aspect of the stent so it’s easy to release & you have a better view

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls We backload LAMS and cardiac septal occluders (larger than 20mm) in the same way and keep a dental floss attached on proximal flange for traction and better control during deployment

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls Useful technique if scope goes through the area where you want to deploy stent or very short stricture otherwise the original cold axios may be an easier/cheaper option

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @MLongMD @MendozaLadd @PerelmansPearls Oh nice! Gives such better control!

@RashidLui @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls This is satisfying to watch!

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls @SanchezLunaMD

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls Excellent!!, two questions, how many millimeters is the caliber of the working channel of that endoscope? Doesn't the Stent lose its shape when introduced through that channel?

@RashidLui @AdvaniRashmiMD @ChahalPrabhleen @SighPichamol @allie_schulman @SunilAminMD @TrieuMD @MLongMD @MendozaLadd @PerelmansPearls Just a doubt Hw if push technique fails(sir can u please share a video of live procedure if possible) How about loading the same stent in its delivery system(tough indeed but possible) TFS this wonderful idea