OBJECTIVES: The aim of this study was to evaluate the technical feasibility of endosonographically-assisted transesophageal access for vagotomy, esophagomyotomy, and lymphadenectomy in a nonsurvival study with six porcine models in an animal laboratory with general anesthesia. METHODS: Saline/hydroxypropylmethylcellulose (HPMC) was injected into the submucosa with a subsequent biliary balloon dissection, creating a substantial submucosal space for a cap-fitted endoscope. A distal esophageal myotomy was performed after access into the thoracic cavity. Over the course of 6 pigs, esophagomyotomy (simulating a Heller myotomy), vagotomy, and lymphadenectomy were performed. The esophageal insertion/access site was sealed by the flap of mucosa. RESULTS: Using a midesophageal entrance point, successful thoracic access and therapeutic interventions involving the esophagus and periesophageal structures were performed in 6 pigs. CONCLUSIONS: The submucosal saline/HPMC tunneling technique allowed for successful access to the upper mediastinum through the esophagus with feasible therapeutic interventions.
OBJECTIVES: The aim of this study was to evaluate the technical feasibility of endosonographically-assisted transesophageal access for vagotomy, esophagomyotomy, and lymphadenectomy in a nonsurvival study with six porcine models in an animal laboratory with general anesthesia. METHODS:Saline/hydroxypropylmethylcellulose (HPMC) was injected into the submucosa with a subsequent biliary balloon dissection, creating a substantial submucosal space for a cap-fitted endoscope. A distal esophageal myotomy was performed after access into the thoracic cavity. Over the course of 6 pigs, esophagomyotomy (simulating a Heller myotomy), vagotomy, and lymphadenectomy were performed. The esophageal insertion/access site was sealed by the flap of mucosa. RESULTS: Using a midesophageal entrance point, successful thoracic access and therapeutic interventions involving the esophagus and periesophageal structures were performed in 6 pigs. CONCLUSIONS: The submucosal saline/HPMC tunneling technique allowed for successful access to the upper mediastinum through the esophagus with feasible therapeutic interventions.
Authors: Brian G Turner; Denise W Gee; Sevdenur Cizginer; Min-Chan Kim; Mari Mino-Kenudson; Patricia Sylla; William R Brugge; David W Rattner Journal: Gastrointest Endosc Date: 2010-06-22 Impact factor: 9.427
Authors: Henry Córdova; Raúl San José Estépar; Antonio Rodríguez-D'Jesús; Graciela Martínez-Pallí; Pedro Arguis; Cristina Rodríguez de Miguel; Ricard Navarro-Ripoll; Juan M Perdomo; Miriam Cuatrecasas; Josep Llach; Kirby G Vosburgh; Gloria Fernández-Esparrach Journal: Gastrointest Endosc Date: 2013-01 Impact factor: 9.427