BACKGROUND: Transgastric flexible endoscopic anastomosis might offer advantages over open and laparoscopic surgery, especially for bariatrics or patients with obstructive malignancy. OBJECTIVE: To develop methods for performing transgastric anastomosis. DESIGN/ RESULTS: Twelve gastrojejunal anastomoses were formed in pigs weighing 27 kg to 38 kg (6 each in survival and nonsurvival groups) by using a per-oral double-channel gastroscope. The stomach was penetrated with a needle-knife guidewire combination and bow-sphincterotome incision. The small intestine (SI) was grasped with a snare-over-forceps method and pulled into the stomach for suturing. Sutures were placed in pairs through the deep muscle of the stomach and small intestine to join the tissues securely. The SI was incised with a needle-knife to open the anastomosis. Anastomoses were placed close to the cardioesophageal junction for bariatric purposes or in the antrum for pancreatic bypass. Survival studies in 6 pigs showed anastomosis patency at 7 to 10 days. CONCLUSION: Gastrojejunal anastomosis was accomplished via the transgastric route by using a new double-channel endoscopic method.
BACKGROUND: Transgastric flexible endoscopic anastomosis might offer advantages over open and laparoscopic surgery, especially for bariatrics or patients with obstructive malignancy. OBJECTIVE: To develop methods for performing transgastric anastomosis. DESIGN/ RESULTS: Twelve gastrojejunal anastomoses were formed in pigs weighing 27 kg to 38 kg (6 each in survival and nonsurvival groups) by using a per-oral double-channel gastroscope. The stomach was penetrated with a needle-knife guidewire combination and bow-sphincterotome incision. The small intestine (SI) was grasped with a snare-over-forceps method and pulled into the stomach for suturing. Sutures were placed in pairs through the deep muscle of the stomach and small intestine to join the tissues securely. The SI was incised with a needle-knife to open the anastomosis. Anastomoses were placed close to the cardioesophageal junction for bariatric purposes or in the antrum for pancreatic bypass. Survival studies in 6 pigs showed anastomosis patency at 7 to 10 days. CONCLUSION: Gastrojejunal anastomosis was accomplished via the transgastric route by using a new double-channel endoscopic method.
Authors: Anders Meller Donatsky; Luise Andersen; Ole Lerberg Nielsen; Barbara Juliane Holzknecht; Peter Vilmann; Søren Meisner; Lars Nannestad Jørgensen; Jacob Rosenberg Journal: Surg Endosc Date: 2012-01-12 Impact factor: 4.584
Authors: Manish M Tiwari; Jason F Reynoso; Amy C Lehman; Albert W Tsang; Shane M Farritor; Dmitry Oleynikov Journal: World J Gastrointest Surg Date: 2010-06-27
Authors: Vimal K Narula; Lynn C Happel; Kevin Volt; Simon Bergman; Jason C Roland; Rebecca Dettorre; David B Renton; Kevin M Reavis; Bradley J Needleman; Dean J Mikami; E Christopher Ellison; W Scott Melvin; Jeffrey W Hazey Journal: Surg Endosc Date: 2008-10-15 Impact factor: 4.584