Magnetic balloon–assisted percutaneous endoscopic jejunostomy

Q3 Medicine

VideoGIE Pub Date : 2026-06-01 Epub Date: 2026-02-05 DOI:10.1016/j.vgie.2026.02.001

Wesley Wright MD, Matthew R. Krafft MD

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引用次数: 0

Abstract

Background and Aims

Magnetic balloon technology was created to assist in colonic loop reduction in cases of difficult or failed colonoscopy. It has since been recognized that the device can facilitate percutaneous endoscopic jejunostomy (PEJ) by readying a jejunal puncture point. This case describes magnetic balloon–assisted PEJ placement.

Methods

A patient with obesity with prior Roux-en-Y gastric bypass required percutaneous enteral feeding tube placement. Percutaneous endoscopic gastrostomy insertion was not possible because of intrathoracic location of the gastric pouch. A jejunal puncture point was not identifiable using standard techniques because of central adiposity (eg, transillumination and 1-to-1 palpation).

Results

A ferromagnetic balloon and permanent magnet were used to magnetically attract and anchor a loop of jejunal Roux limb to the anterior abdominal wall, thereby enabling identification of a jejunal puncture point using 1-to-1 palpation. A 20F “pull-type” enteral feeding tube was inserted into the jejunal Roux limb. The procedure was completed without fluoroscopy. No adverse events occurred.

Conclusions

Historically, jejunal puncture point localization and/or trocar passage has been the rate-limiting step of PEJ, accounting for approximately 13% technical failure rate. Magnetic balloon technology may assist with transabdominal jejunal access by magnetically attracting the jejunum to the abdominal wall.

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磁球囊辅助经皮内镜空肠造口术

背景和目的磁球囊技术的发明是为了在结肠镜检查困难或失败的情况下帮助结肠袢缩小。人们已经认识到，该装置可以通过准备空肠穿刺点来促进经皮内镜空肠造口术（PEJ）。本病例描述磁球囊辅助PEJ放置。方法1例肥胖患者既往行Roux-en-Y胃旁路术，经皮置胃内喂养管。由于胃囊位于胸内，经皮内镜胃造口术不可行。由于中心性肥胖（如透照和1对1触诊），使用标准技术无法识别空肠穿刺点。结果利用铁磁球囊和永磁体将空肠Roux肢袢磁性吸引并锚定在前腹壁上，采用1对1触诊法确定空肠穿刺点。将20F“拉式”肠内喂食管插入空肠Roux肢体。手术在没有透视的情况下完成。无不良事件发生。从历史上看，空肠穿刺点定位和/或套管针通过是PEJ的限速步骤，约占13%的技术失败率。磁球囊技术可以通过磁性吸引空肠到腹壁来辅助经腹空肠通路。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.