Various applications of lumen-apposing metal stents in challenging gastrointestinal and pancreaticobiliary cases

INTRODUCTION: Endoscopic ultrasound (EUS) was initially developed as a diagnostic modality but has in the past years gained a role in various therapeutic applications involving the gastrointestinal tract and surrounding structures. The advent of lumen apposing metal stents (LAMS) revolutionized the field of therapeutic EUS. LAMS enable the creation of an anastomotic conduit between the gastrointestinal tract wall and adjacent fluid-filled cavities or other parts of the gastrointestinal tract. AREAS COVERED: In this review, we discuss the history of the development of the LAMS, the concept behind the LAMS, commercially available LAMS, indications of LAMS, and LAMS related adverse events. We conducted a literature search of the PubMed database for studies published between January 2011 and august 2025 using combinations of relevant keywords. EXPERT OPINION: The availability of LAMS has revolutionized the scope of interventional EUS in various gastrointestinal conditions. As new indications continue to evolve, obtaining informed consent, maintaining proficiency in interventional EUS, and anticipating potential complications are the key to clinical success.