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. 2020 Sep;16(9):458-463.

Endoscopic Approaches to Gastroparesis

Kevin Liu  1 , Thomas Enke  2 , Aziz Aadam  1
Affiliations

Endoscopic Approaches to Gastroparesis

Kevin Liu et al. Gastroenterol Hepatol (N Y). 2020 Sep.

Abstract

Gastroparesis is a complex syndrome with multiple underlying etiologies and pathophysiologies that can cause significant morbidity for patients. Currently, there are limited effective and durable medical and surgical treatments for patients with gastroparesis. As such, there has been recent innovation and development in minimally invasive endoscopic treatments for gastroparesis. Endoscopic therapies that have been investigated for gastroparesis include enteral feeding tube placement, intrapyloric botulinum toxin injection, transpyloric stenting, gastric peroral endoscopic myotomy, and gastric electrical stimulation. This article aims to assess the effectiveness of current endoscopic therapies, as well as discuss future directions for endoscopic therapies, in the management of gastroparesis.

Keywords: Gastroparesis; endoscopy; myotomy; stent; transpyloric; treatments.

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Conflict of interest statement

The authors have no relevant conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
A: A lumen-apposing metal stent is deployed across the pylorus. B: Endoscopic suturing is used to fixate the stent to the gastric wall to prevent migration. C: A transpyloric lumenapposing metal stent is fixated in place after endoscopic suturing.
Figure 2.
Figure 2.
A diagram depicting the 4 principal steps of gastric peroral endoscopic myotomy.
Figure 3.
Figure 3.
A: Creation of a submucosal tunnel using an endoscopic knife. B: Exposure and identification of the pyloric ring (arrows). C: Full-thickness myotomy with exposure of the serosal layer. D: Closure of the mucosal incision with endoscopic clip placement.
See this image and copyright information in PMC

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