VideoGIE| Volume 84, ISSUE 6, P1063, December 2016

Technical steps for removal of duodenojejunal bypass liner (endobarrier device)

      The duodenojejunal bypass liner (Endobarrier Gastrointestinal Liner, GI Dynamics, Lexington, Mass, USA) is an endoscopically placed and removable device that creates a duodenojejunal bypass by isolating food from biliopancreatic secretions and the duodenal mucosa, aiming to induce weight loss and improvement in type 2 diabetes mellitus. The length of the treatment is usually 1 year. We describe the case of a 60-year-old woman with a medical history of hypertension, morbid obesity (body mass index 42.9 kg/m2), type 2 diabetes (HbA1c 7.3%), and sleep apnea. The duodenojejunal bypass liner was placed endoscopically in March 2015 (Fig. 1). The device was explanted after 10 months because the patient needed orthopedic surgery. Upon removal of the device, the patient’s weight was 84 kg, her body mass index was 33 kg/m2, and her HbA1c was 6.6%. About 1000 patients have had this device implanted in different countries since 2005. The device has been put on hold by the US Food and Drug Administration but is Conformité Européene (CE) marked and available also in Australia. In Video 1 (available online at, the necessary steps for safe removal of the endobarrier device are demonstrated.
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      Figure 1Endobarrier thread hooked with the dedicated hook.
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