BACKGROUND: STAT, or the self-approximating transluminal access technique, has been previously described and involves the dissection of a submucosal tunnel for peritoneal or mediastinal access from the esophagus and stomach. The objective of this study was to assess the safety and reliability of gastric access and closure in a porcine experience using STAT for natural orifice transluminal endoscopic surgery (NOTES). METHODS: A review of the experience using STAT access tunnels for intraperitoneal access was performed in 39 female pigs at a university animal lab. All animals underwent a predetermined NOTES surgical procedure using a STAT transgastric access tunnel based on a specific protocol. Details of the procedure, complications, and clinical course were documented. Necropsy was performed at 2 weeks. The main outcome measurements were clinical or necropsy evidence of gastrostomy site leak or inadequate access site closure. RESULTS: STAT was successful in providing safe peritoneal access in all animals. The width of the tunnel ranged from 1.5 to 5.5 cm and the length was up to 27 cm. There was no evidence of gastrostomy site leak in any animals. One animal required a single laparoscopic suture to help with tunnel closure. CONCLUSION: STAT provides safe transgastric access and allows secure closure of the gastrotomy site.
BACKGROUND: STAT, or the self-approximating transluminal access technique, has been previously described and involves the dissection of a submucosal tunnel for peritoneal or mediastinal access from the esophagus and stomach. The objective of this study was to assess the safety and reliability of gastric access and closure in a porcine experience using STAT for natural orifice transluminal endoscopic surgery (NOTES). METHODS: A review of the experience using STAT access tunnels for intraperitoneal access was performed in 39 female pigs at a university animal lab. All animals underwent a predetermined NOTES surgical procedure using a STAT transgastric access tunnel based on a specific protocol. Details of the procedure, complications, and clinical course were documented. Necropsy was performed at 2 weeks. The main outcome measurements were clinical or necropsy evidence of gastrostomy site leak or inadequate access site closure. RESULTS: STAT was successful in providing safe peritoneal access in all animals. The width of the tunnel ranged from 1.5 to 5.5 cm and the length was up to 27 cm. There was no evidence of gastrostomy site leak in any animals. One animal required a single laparoscopic suture to help with tunnel closure. CONCLUSION: STAT provides safe transgastric access and allows secure closure of the gastrotomy site.
Authors: Kazuki Sumiyama; Christopher J Gostout; Elizabeth Rajan; Timothy A Bakken; Mary A Knipschield; Sydney Chung; Peter B Cotton; Robert H Hawes; Anthony N Kalloo; Sergey V Kantsevoy; Pankaj J Pasricha Journal: Gastrointest Endosc Date: 2007-06 Impact factor: 9.427
Authors: H Inoue; H Minami; Y Kobayashi; Y Sato; M Kaga; M Suzuki; H Satodate; N Odaka; H Itoh; S Kudo Journal: Endoscopy Date: 2010-03-30 Impact factor: 10.093
Authors: Stefan von Delius; Sonja Gillen; Emmanouil Doundoulakis; Armin Schneider; Dirk Wilhelm; Adam Fiolka; Stefan Wagenpfeil; Roland M Schmid; Hubertus Feussner; Alexander Meining Journal: Gastrointest Endosc Date: 2008-06-17 Impact factor: 9.427
Authors: Jihad H Kaouk; Wesley M White; Raj K Goel; Stacy Brethauer; Sebastien Crouzet; Raymond R Rackley; Courtenay Moore; Michael S Ingber; Georges-Pascal Haber Journal: Urology Date: 2009-07 Impact factor: 2.649
Authors: Jeffrey W Hazey; Vimal K Narula; David B Renton; Kevin M Reavis; Christopher M Paul; Kristen E Hinshaw; Peter Muscarella; E Christopher Ellison; W Scott Melvin Journal: Surg Endosc Date: 2007-08-14 Impact factor: 4.584