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ABSTRACT: Multiple studies have demonstrated the feasibility of peroral transgastric endoscopic procedures in animal models. The aim of the study was to evaluate the feasibility of a peroral transgastric endoscopic approach to repair abdominal wall hernias.
We performed acute experiments under general anesthesia with endotracheal intubation using 50-kg pigs. Following peroral intubation an incision of the gastric wall was made and the endoscope was advanced into the peritoneal cavity. An internal anterior abdominal wall incision was performed with a needle knife to create an animal model of a ventral hernia. After hernia creation an endoscopic suturing device was used for primary repair of the hernia. After completion of the hernia repair the endoscope was withdrawn into the stomach and the gastric wall incision was closed with endoscopic clips. Then the animals were killed for necropsy.
Two acute experiments were performed. Incision of the gastric wall was easily achieved with a needle knife and a pull-type sphincterotome. A large (3 x 2 cm) defect of the abdominal wall (ventral hernia model) was closed with five or six sutures using the endoscopic suturing device. Postmortem examination revealed complete closure of the hernia without any complications.
Transgastric endoscopic primary repair of ventral hernias in a porcine model is feasible and may be technically simpler than laparoscopic surgery.
Endoscopy 06/2007; 39(5):390-3. DOI:10.1055/s-2007-966426 · 5.20 Impact Factor
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ABSTRACT: Gastric restrictive procedures are widely used for the surgical treatment of morbid obesity.
Our purpose was to determine the technical feasibility of endoscopic gastric reduction in a live porcine model.
Acute experiments on 50-kg pigs under general anesthesia.
After per-oral intubation, the endoscope was inserted into the stomach. A fishing line was sutured to the gastric wall along the fundus approximately 5 cm below the gastroesophageal junction with a prototype endoscopic suturing device (Olympus, Eagle Claw). Then the fishing line was tied to create a small proximal pouch. A flexible sheath was placed on one side of fishing line and additional knots were tied, forming a ring at the outlet of the gastric pouch. The ring was anchored to gastric wall with additional stitches, completing the gastric reduction. Then the animals were killed for postmortem examination.
The feasibility of endoscopic gastric reduction.
We performed 4 acute experiments. It required 12 to 14 stitches in each animal to create gastric reduction. There were no technical problems during the procedures. Postmortem examination demonstrated an approximately 30-mL gastric pouch separated from the rest of the stomach by the line of stitches. There were no complications during the procedure.
We have not performed survival experiments to determine how long our gastric reduction will last.
Endoscopic gastric reduction is technically feasible on a live porcine model.
Gastrointestinal Endoscopy 04/2007; 65(3):510-3. DOI:10.1016/j.gie.2006.07.045 · 4.90 Impact Factor
Annual Meeting of the; 04/2005