Endoscopic GI anastomosis: a review of established techniques

Technological advancements in the field of therapeutic endoscopy have led to the development of minimally invasive techniques to create a gastrointestinal anastomosis without requiring surgery. Examples of the potential clinical applications of these novel endoscopic techniques can be bypassing malignant and benign gastric outlet obstruction, providing access to the pancreatobiliary tree in those who have undergone Roux-en-Y gastric bypass and to relieve pancreatobilliary symptoms in afferent loop syndrome. Endoscopic gastrointestinal anastomosis is less invasive and expensive than surgical approaches, which may be more appealing to patients and result in improved outcomes. The aim of this review is to present the evolution of luminal endoscopic gastroenteric or enteroenteric anastomosis dating back to the first compression devices and to describe the current clinical techniques being used today such as magnets, natural orifice transluminal endoscopic surgery and EUS-guided techniques.