Vacuum stent: a game-changer in endoscopic multistep management of leakage following bariatric surgery

The most common adverse events following laparoscopic sleeve gastrectomy are leaks in the staple line, which occur in up to 2% of cases [1]. Apart from surgical repair, various endoscopic treatment options have been explored such as placement of self-expandable metal stents (SEMSs) [2]. Recently, endoscopic vacuum therapy (EVT) has become a valid alternative owing to a clinical success rate of up to 95%, shorter treatment duration, and lower mortality rate [3]. However, intraluminal EVT in the upper gastrointestinal tract prevents early enteral nutrition. The VACStent (Micro-Tech Europe, Dusseldorf, Germany) is a new treatment option that overcomes the drawbacks of endoluminal EVT and combines EVT with the advantages of covered stenting.