A novel double-endoloop technique for natural orifice transluminal endoscopic surgery gastric access site closure

Autor: Eva Kieslichova, Martin Oliverius, Julius Spicak, Marek Benes, Martin Krak, Matej Kocik, Tomas Hucl, Jana Maluskova
Rok vydání: 2010
Předmět:
Zdroj: Gastrointestinal Endoscopy. 71:806-811
ISSN: 0016-5107
DOI: 10.1016/j.gie.2009.10.058
Popis: Background Effective and safe access site closure is critical for clinical application of natural orifice transluminal endoscopic surgery. Objective The current study evaluated a simple novel technique of gastrotomy closure. Design Feasibility study with a survival animal model. Setting Animal laboratory. Subjects Ten female domestic pigs. Interventions Endoscopic closure of a gastrotomy incision was evaluated in 10 pigs in a survival study. A standard double-channel endoscope was advanced into the peritoneal cavity through an incision made by a needle-knife and an 18-mm dilation balloon. After peritoneoscopy and salpingectomy, gastric closure was performed by using an endoscopic grasper and sequential application of 2 endoloops. After a follow-up period of 1 to 3 weeks, the pigs were killed for postmortem examination. Main Outcome Measurements Feasibility, efficiency, and safety of a novel closure technique. Results Correct positioning and delivery of endoloops was achieved in all animals in a median time of 17 minutes (range 13-25 minutes). All animals survived without complications. Postmortem examination demonstrated patent full-thickness gastric closure without any evidence of infection. Limitations Feasibility study with a small number of subjects in a porcine model. Conclusion Double endoloop technique represents a novel, simple, safe, and efficient means of gastric access site closure in natural orifice transluminal endoscopic surgery.
Databáze: OpenAIRE
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