Transgastric endoscopic gastrojejunostomy using holing followed by interrupted suture technique in a porcine model

AIM: To demonstrate the feasibility and reproducibility of a pure natural orifice transluminal endoscopic surgery(NOTES) gastrojejunostomy using holing followed by interrupted suture technique using a single endoloop matched with a pair of clips in a non-survival porcine model.METHODS: NOTES gastroj...

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Published inWorld journal of gastrointestinal endoscopy Vol. 7; no. 15; pp. 1186 - 1190
Main Authors Chen, Su-Yu, Shi, Hong, Jiang, Sheng-Jun, Wang, Yong-Guang, Lin, Kai, Xie, Zhao-Fei, Liu, Xiao-Jing
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 25.10.2015
Subjects
Basic Study
Endoscopic
gastrojejunostomy;Endoloop;Endoscopic
Pigs
Endoloop
Endoscopic gastrojejunostomy
Endoscopic clips
Natural orifice transluminal endoscopic surgery
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Summary:AIM: To demonstrate the feasibility and reproducibility of a pure natural orifice transluminal endoscopic surgery(NOTES) gastrojejunostomy using holing followed by interrupted suture technique using a single endoloop matched with a pair of clips in a non-survival porcine model.METHODS: NOTES gastrojejunostomy was performed on three female domestic pigs as follows: Gastrostomy, selection and retrieval of a free-floating loop of the small bowel into the stomach pouch, hold and exposure of the loop in the gastric cavity using a submucosal inflation technique, execution of a gastro-jejunal mucosal-seromuscular layer approximation using holing followed by interrupted suture technique with endoloop/clips, and full-thickness incision of the loop with a Dual knife.RESULTS: Pure NOTES side-to-side gastrojejunostomy was successfully performed in all three animals. No leakage was identified via methylene blue evaluation following surgery.CONCLUSION: This novel technique for preforming a gastrointestinal anastomosis exclusively by NOTES is technically feasible and reproducible in an animal model but warrants further improvement.
Bibliography:Endoscopic gastrojejunostomy;Endoloop;Endoscopic c
AIM: To demonstrate the feasibility and reproducibility of a pure natural orifice transluminal endoscopic surgery(NOTES) gastrojejunostomy using holing followed by interrupted suture technique using a single endoloop matched with a pair of clips in a non-survival porcine model.METHODS: NOTES gastrojejunostomy was performed on three female domestic pigs as follows: Gastrostomy, selection and retrieval of a free-floating loop of the small bowel into the stomach pouch, hold and exposure of the loop in the gastric cavity using a submucosal inflation technique, execution of a gastro-jejunal mucosal-seromuscular layer approximation using holing followed by interrupted suture technique with endoloop/clips, and full-thickness incision of the loop with a Dual knife.RESULTS: Pure NOTES side-to-side gastrojejunostomy was successfully performed in all three animals. No leakage was identified via methylene blue evaluation following surgery.CONCLUSION: This novel technique for preforming a gastrointestinal anastomosis exclusively by NOTES is technically feasible and reproducible in an animal model but warrants further improvement.
Su-Yu Chen;Hong Shi;Sheng-Jun Jiang;Yong-Guang Wang;Kai Lin;Zhao-Fei Xie;Xiao-Jing Liu;Department of Gastrointestinal Endoscopy,Fujian Provincial Tumor Hospital,Teaching Hospital of Fujian Medical University;Depart-ment of Minimally Invasive Surgery,Beijing Chuiyangliu Hospital,Institute of Minimally Invasive Medicine of Tongji University;Department of General Surgery,Fuzhou Seventh Hospital
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Telephone: +86-591-83660063 Fax: +86-591-83660063
Correspondence to: Hong Shi, MD, Department of Gastrointestinal Endoscopy, Fujian Provincial Tumor Hospital, Teaching Hospital of Fujian Medical University, No. 420 FuMa Road, Fuzhou 350014, Fujian Province, China. endoshihong@hotmail.com
Author contributions: Chen SY and Shi H were responsible for the study conception and design, and endoscopic procedures; all authors preformed the endoscopic procedures together; Chen SY drafted the manuscript; Shi H and Wang YG revised and finalized the manuscript; all the authors contribute to the manuscript.
ISSN:1948-5190
1948-5190
DOI:10.4253/wjge.v7.i15.1186