BACKGROUND: In natural orifice transluminal endoscopic surgery (NOTES), procedures are performed with an endoscope passed through a natural orifice. One of the most important factors that will determine the future of transgastric NOTES is obtaining a reliable closure of the access site. The aim of this study was to determine the efficacy and safety of transgastric closure using the over-the-scope clip (OTSC) system or T-bar sutures. METHODS: We performed a survival study that included 15 pigs. A standardized transgastric approach to the peritoneal cavity and a peritoneoscopy were performed. The gastrotomy was closed using the OTSC system or T-bar sutures. The gastrotomy closure was tested for leaks with the methylene blue test. All animals were observed for 2 weeks before they were sacrificed and necropsy was performed. Histopathological examination of tissue samples retrieved from the access sites was performed. RESULTS: There were no perioperative complications. The methylene blue test did not demonstrate any leakage of fluid. Necropsy after 2 weeks confirmed completeness of gastric closure in all animals with full-thickness healing and no spillage of gastric contents into the peritoneal cavity. No differences between the OTSC system and T-bar sutures were observed. CONCLUSION: We observed no differences between the efficacy and safety of the OTSC system and those of T-bar sutures used in closing gastric incisions in NOTES. Both methods are safe and effective.
BACKGROUND: In natural orifice transluminal endoscopic surgery (NOTES), procedures are performed with an endoscope passed through a natural orifice. One of the most important factors that will determine the future of transgastric NOTES is obtaining a reliable closure of the access site. The aim of this study was to determine the efficacy and safety of transgastric closure using the over-the-scope clip (OTSC) system or T-bar sutures. METHODS: We performed a survival study that included 15 pigs. A standardized transgastric approach to the peritoneal cavity and a peritoneoscopy were performed. The gastrotomy was closed using the OTSC system or T-bar sutures. The gastrotomy closure was tested for leaks with the methylene blue test. All animals were observed for 2 weeks before they were sacrificed and necropsy was performed. Histopathological examination of tissue samples retrieved from the access sites was performed. RESULTS: There were no perioperative complications. The methylene blue test did not demonstrate any leakage of fluid. Necropsy after 2 weeks confirmed completeness of gastric closure in all animals with full-thickness healing and no spillage of gastric contents into the peritoneal cavity. No differences between the OTSC system and T-bar sutures were observed. CONCLUSION: We observed no differences between the efficacy and safety of the OTSC system and those of T-bar sutures used in closing gastric incisions in NOTES. Both methods are safe and effective.
Authors: Sanjay B Jagannath; Sergey V Kantsevoy; Cheryl A Vaughn; Sydney S C Chung; Peter B Cotton; Christopher J Gostout; Robert H Hawes; Pankaj J Pasricha; Diana G Scorpio; Carolyn A Magee; Laurie J Pipitone; Anthony N Kalloo Journal: Gastrointest Endosc Date: 2005-03 Impact factor: 9.427
Authors: M Ryou; R D Pai; R Pai; J S Sauer; J Sauer; D W Rattner; D Rattner; C C Thompson; C Thompson Journal: Surg Endosc Date: 2006-12-08 Impact factor: 3.453
Authors: Arthur Schmidt; Karl-Hermann Fuchs; Karel Caca; Armin Küllmer; Alexander Meining Journal: Dtsch Arztebl Int Date: 2016-02-26 Impact factor: 5.594
Authors: Alberto Arezzo; Carsten Zornig; Hamid Mofid; Karl-Hermann Fuchs; Wolfram Breithaupt; José Noguera; Georg Kaehler; Richard Magdeburg; Silvana Perretta; Bernard Dallemagne; Jacques Marescaux; Catalin Copaescu; Florin Graur; Andrei Szasz; Antonello Forgione; Raffaele Pugliese; Gerhard Buess; Hemanga K Bhattacharjee; Giuseppe Navarra; Mario Godina; Kirill Shishin; Mario Morino Journal: Surg Endosc Date: 2013-03-22 Impact factor: 4.584