PMC6358575_01
The Gastroseal stent inside gastric sleeve.
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F1
A novel, fully covered, expandable metallic stent was inserted with the upper edge lying in the esophagus and the lower edge lying in the duodenum (Gastroseal , M.I.Tech, Seoul, South Korea) (Figure 1).
(A) The knitted mesh allows complete flexibility and conformity with a gastric sleeve anatomy. The upper edge is curved inward slightly and the lower edge is completely round to reduce trauma to the esophagus and duodenal bulb, respectively. (B) The distal edge of the Gastroseal stent is rounded to reduce trauma to the duodenal bulb or antrum.
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F2
Finally, a large diameter (shaft 28 mm; edges 36 mm) ensures a complete seal and reduces the risk of migration (Figure 2).
Gastroesophageal junction leak (left); healed leak after stent removal (right).
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F3
The stent was removed by a forceps revealing complete healing of the previously described fistula (Figure 3).