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Endoscopy 2012; 44(05): 493-498
DOI: 10.1055/s-0031-1291689
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Transgastric endoscopic gastroenterostomy using a partially covered occluder: a canine feasibility study[1]

H. Luo
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
Y. Pan
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
L. Min
2   Xi’an Aerospace General Hospital, Xi’an, China
,
L. Zhao
3   Department of Radiation Oncology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
J. Li
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
J. Leung
4   Section of Gastroenterology, Sacramento Veterans Affairs Medical Center, Mather, California, USA
,
L. Xue
5   Department of Cardiology, Jinan Military General Hospital, Jinan, China
,
Z. Yin
6   WEGO Medical System Company, Weihai, China
,
X. Liu
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
Z. Liu
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
A. Sun
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
C. Li
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
K. Wu
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
X. Guo
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
,
D. Fan
1   Department of Gastroenterology, Xijing Hospital, Fourth Military Medical University, Xi’an, China
› Author Affiliations
Further Information

Publication History

submitted 05 August 2011

accepted after revision 28 November 2011

Publication Date:
24 April 2012 (online)

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Background and study aims: The use of natural orifice transluminal endoscopic surgery (NOTES) for gastroenterostomy has been previously reported, but it remains technically challenging and additional assistance is often needed. The aim of this study was to develop and evaluate a novel method for the creation of a gastroenterostomy using NOTES with an occluder.

Methods: Transgastric endoscopic gastroenterostomy was performed in 12 healthy female dogs using a therapeutic upper gastrointestinal endoscope and a partially covered occluder. The occluder was removed with a snare 1 week later. The patency of the gastroenterostomy was confirmed by endoscopy, contrast radiological study, necropsy, and histological examination after 2 weeks.

Results: NOTES gastroenterostomy with an occluder was successful in all 12 dogs. The mean operative time was 32.3 ± 10.3 min (range 20.3 – 53.5). One dog (the first; 8.3 %) died 4 days after the operation of severe intra-abdominal infection due to incorrect deployment of the occluder and poor bowel preparation. Minor bleeding occurred at the anastomosis after removal of the occluder in two of the remaining dogs (18.2 %). Necropsy revealed postoperative adhesions that had developed at the anastomotic site in one dog (9.1 %). No anastomotic leakage or intestinal obstruction was observed. Complete healing of the anastomosis was confirmed on histological evaluation.

Conclusion: Gastroenterostomy performed entirely by NOTES using an occluder was technically feasible in this survival animal model.

1 H. Luo, Y. Pan, L. Min and L. Zhao contributed equally to this work.


 

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