Implantation of a duodenal–jejunal bypass liner for managing type 2 diabetes

The procedure

This procedure aims to lower blood sugar levels by acting as a barrier between food and the upper part of the bowel. It delays food mixing with digestive juices.

Under a general anaesthetic or sedative, a thin flexible tube with a camera on the end (endoscope) is inserted into the patient's mouth and moved through the food pipe and stomach into the bowel. The liner is moved through the tube, attached to the upper part of the bowel by a metal anchor and then extended about 60 cm down the bowel.

Straight after the procedure, patients can only have fluids, and then move on to eating semi‑solid foods and solid foods over several weeks. The liner is removed within a year under a sedative and using an endoscope.