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Endoluminal Stenting

Endoluminal stenting is an endoscopic procedure that your gastroenterologist
performs to treat an obstruction or perforation in the gastrointestinal tract. The
test is performed using an endoscope, which is a thin tube with a camera and a light
on its end. The doctor inserts the scope through your mouth or anus and advances
it to the area of obstruction or perforation. The images are transmitted from the
scope to a monitor so the doctor can see inside and around your GI tract. The scope
also has a channel that the doctor can use to insert instruments and perform
diagnostic and therapeutic interventions such as placing an endoluminal stent.
An endoluminal stent is a self-expanding metal stent that will be placed through
the scope’s instrument channel at the area of the obstruction or perforation.
Depending on the reason for the stent placement, the stent can be removed in a
later procedure once the obstruction or perforation has resolved. Some common
causes of gastrointestinal obstruction are cancers of the esophagus, stomach,
duodenum, colon, and rectum. There can also be obstructions related to
inflammatory bowel disease, esophageal acid reflux, radiation, and prior
gastrointestinal surgeries. Some common causes of perforation are
gastrointestinal surgeries, diverticulitis, inflammatory bowel disease,
gastrointestinal cancer, trauma, and rarely endoscopy.

Endoluminal stenting is a safe, effective, and well-tolerated procedure. It can be
used to treat gastrointestinal obstruction which can present as abdominal pain,
nausea, vomiting, and inability to pass gas/stool from below. Additionally,
endoluminal stenting can treat gastrointestinal perforation which can present as
severe abdominal pain, fevers, chills, and inability to pass gas/stool from below.
Patients are considered for endoluminal stenting typically when surgical treatment
is not feasible or recommended for patient safety reasons.

Preparing for your endoluminal stenting:

You will receive specific instructions when you are scheduled for the procedure
explaining the preparation process. For endoluminal stenting of the esophagus,
stomach, or duodenum this is usually very simple as you do not need to drink any
cleansing solution before an upper endoscopy. You cannot eat any solid food the
day of your procedure, but you can usually continue to drink clear liquids up to four
hours before your procedure. For endoluminal stenting of the rectum or the colon,
you will be given instructions to use enemas and possibly drink laxatives the day
before and the morning of the procedure.
Before the procedure, you will be evaluated by the anesthesia team and the nursing
staff. You will be asked to put a gown on. Intravenous access will be placed and
your vital signs checked. Your doctor will talk to you about the risks, benefits, and
alternatives of the procedure and you will be asked to sign an informed consent
form to give the doctor permission to perform the procedure.

The procedure:

The procedure is performed in a private room with only your
gastroenterologist, the anesthesiologist, and the nurse and tech assisting in
the procedure present in the room. Sedation will be administered through
the IV line and you will be asleep and comfortable. The scope is inserted
through the mouth or the anus and advanced to the area to be examined.
Your doctor will carefully examine your GI tract lining. If needed, an
endoluminal stent can be introduced through the scope and advanced under
fluoroscopic (x-ray) visualization to stent the obstructed or perforated
area.
After the procedure:
Endoluminal stenting usually takes 20 minutes to 45 minutes. When the
procedure is over, the sedation will be stopped and you will wake up and be

taken to the recovery room. Most patients wake up not even realizing that
the procedure has occurred. After the sedation completely wears off, your
doctor will talk to you about the procedure and discuss with you the
findings and the recommendations.
You will need someone to take you home after the procedure as after
receiving sedation you are not allowed to drive, go to work or leave the
endoscopy unit by yourself. The next day you will be back to your normal
routine with some diet modifications to prevent the stent from becoming
clogged.