Endoscopic vertical band gastroplasty with an endoscopic sewing machine.

BACKGROUND: Vertical band gastroplasty is an accepted surgical operation for the treatment of obesity. It is performed by means of an open technique. This is a description of a new endoscopic technique for gastroplasty.
METHODS: An endoscopic sewing machine was mounted on a flexible upper endoscope. On a postmortem specimen of porcine gastroesophageal tissue an area of the stomach, about 8-cm long and 4-cm wide, extending from and in line with the esophagus, was marked. A flexible plastic ring about 3 cm in diameter was sutured to the stomach along the lesser curvature at 8 cm from the gastroesophageal junction with an endoscopic sewing machine. Vertical gastroplasty was accomplished by suturing together the anterior and posterior walls of the stomach with the endoscopic sewing machine. Hence, a gastroplasty was fashioned as an 8-cm-long tube along the lesser curvature of the stomach extending from the gastroesophageal junction to the outlet ring. OBSERVATIONS: An endoscopic gastroplasty for obesity was successfully performed by using an endoscopic sewing machine on a postmortem specimen of porcine stomach.
CONCLUSION: The technical feasibility of endoscopic vertical ring gastroplasty should be tested in a live animal model. This will serve as the next phase in the development of this interventional endoscopic technique, which has potential for clinical applicability.