AIM: To determine the technical feasibility and safety of an endoscopic gastrojejunostomy with a pure natural orifice transluminal endoscopic surgery (NOTES) technique using a T-anchoring device in a porcine survival model. METHODS: An endoscopic gastrojejunostomy with a pure NOTES technique using a T-anchoring device was performed on 10 healthy female minipigs weighing approximately 40 kg each under general anesthesia. All procedures were performed with a transgastric approach using a 2-channel therapeutic endoscope. RESULTS: The transgastric gastrojejunostomy was technically successful in all cases. A total of four to six stitched pairs of a T-anchoring device were used to secure the anastomosis. The median time required to enter the peritoneal cavity and pull the small bowel into the stomach was 34 min (range: 19-41 min); the median time required to suture the anastomosis was 67 min (range: 44-78 min). An obstruction of the efferent limb occurred in one case, and a rupture of the anastomosis site occurred in another case. As a result, the functional success rate was 80% (8/10). Small bowel adhesion to the stomach and liver occurred in one case, but the anastomosis was intact without leakage or obstruction. CONCLUSION: A transgastric gastrojejunostomy with a T-anchoring device may be safe and technically feasible. A T-anchoring device may provide a simple and effective endoscopic suturing method.
AIM: To determine the technical feasibility and safety of an endoscopic gastrojejunostomy with a pure natural orifice transluminal endoscopic surgery (NOTES) technique using a T-anchoring device in a porcine survival model. METHODS: An endoscopic gastrojejunostomy with a pure NOTES technique using a T-anchoring device was performed on 10 healthy female minipigs weighing approximately 40 kg each under general anesthesia. All procedures were performed with a transgastric approach using a 2-channel therapeutic endoscope. RESULTS: The transgastric gastrojejunostomy was technically successful in all cases. A total of four to six stitched pairs of a T-anchoring device were used to secure the anastomosis. The median time required to enter the peritoneal cavity and pull the small bowel into the stomach was 34 min (range: 19-41 min); the median time required to suture the anastomosis was 67 min (range: 44-78 min). An obstruction of the efferent limb occurred in one case, and a rupture of the anastomosis site occurred in another case. As a result, the functional success rate was 80% (8/10). Small bowel adhesion to the stomach and liver occurred in one case, but the anastomosis was intact without leakage or obstruction. CONCLUSION: A transgastric gastrojejunostomy with a T-anchoring device may be safe and technically feasible. A T-anchoring device may provide a simple and effective endoscopic suturing method.
Authors: Stefan von Delius; Johanna Sager; Hubertus Feussner; Dirk Wilhelm; Phillip Thies; Wolfgang Huber; Tibor Schuster; Armin Schneider; Roland M Schmid; Alexander Meining Journal: Gastrointest Endosc Date: 2010-04-08 Impact factor: 9.427
Authors: O Meireles; S V Kantsevoy; A N Kalloo; S B Jagannath; S A Giday; P Magno; S P Shih; E J Hanly; C-W Ko; D M Beitler; M R Marohn Journal: Surg Endosc Date: 2007-04-03 Impact factor: 4.584
Authors: Peter Nau; Joel Anderson; Benjamin Yuh; Peter Muscarella; E Christopher Ellison; Lynn Happel; Vimal K Narula; W Scott Melvin; Jeffrey W Hazey Journal: Surg Endosc Date: 2010-01-07 Impact factor: 4.584
Authors: Suzanne M Jeurnink; Casper H J van Eijck; Ewout W Steyerberg; Ernst J Kuipers; Peter D Siersema Journal: BMC Gastroenterol Date: 2007-06-08 Impact factor: 3.067