geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

A new stapler-based full-thickness transgastric access closure: results from an animal pilot trial


, : A new stapler-based full-thickness transgastric access closure: results from an animal pilot trial. Endoscopy 39(10): 876-880

Reliable closure of the transluminal incision is the crucial step for natural orifice transluminal endoscopic surgery (NOTES) procedures. The aim of this study was to evaluate the feasibility and effectiveness of transgastric access closure with a flexible stapling device in a porcine survival model. We carried out four experiments (two sterile and two nonsterile) on 50 kg pigs. The endoscope was passed through a gastrotomy made with a needle knife and an 18-mm controlled radial expansion dilating balloon. After peritoneoscopy, a flexible linear stapling device (NOLC60, Power Medical Interventions, Langhorne, Pennsylvania, USA) was perorally advanced over a guide wire into the stomach, positioned under endoscopic guidance, and opened to include the site of gastrotomy between its two arms; four rows of staples were fired. One animal was sacrificed 24 hours after the procedure (progression of pre-existing pneumonia). The remaining animals were survived for 1 week and then underwent repeat endoscopy and postmortem examination. Peroral delivery and positioning of the stapling device involved some technical difficulties, mostly due to the short length (60 cm) of the stapling device. The stapler provided complete leak-resistant gastric closure in all pigs. None of the surviving animals had any clinical signs of infection. Necropsy demonstrated an intact staple line with full-thickness healing of the gastrotomy in all animals. Histologic examination confirmed healing, but also revealed intramural micro-abscesses within the gastric wall after nonsterile procedure. Gastrotomy closure with a perorally delivered flexible stapling device created a leak-resistant transmural line of staples followed by full-thickness healing of the gastric wall incision. Increasing the length of the instrument and adding device articulation will further facilitate its use for NOTES procedures.

US$19.90

PMID: 17968803

DOI: 10.1055/s-2007-966896


Other references

Vig, R.; Gordon, J.R.; Thébaud, B.; Befus, A.Dean.; Vliagoftis, H., 2010: The effect of early-life stress on airway inflammation in adult mice. Neonatal stress induces permanent physiological changes that may influence the immune system. Early-life stress increases asthma disease severity in children. We investigated the effects of early-life stress on allergic airway inflammation using a...

Parona, C.F., 1932: Fauna Cretacica di Aurisina (Trieste) (Collezione del Museo di Bologna). Giornale di Geologia Bologna 2: 7: 93-105

Grino, M.; Guillaume, V.; Boudouresque, F.; Margioris, A.N.; Grisoli, F.; Jaquet, P.; Oliver, C.; Conte-Devolx, B., 1988: Characterization of corticotropin-releasing hormone receptors on human pituitary corticotroph adenomas and their correlation with endogenous glucocorticoids. Specific receptors for CRH were identified in five freshly excised pituitary adenomas causing Cushing's disease. Their kinetic properties and mean affinity constant [1.45 +/- 0.38 (+/- SE) nmol/L] were comparable to the characteristics of rat...

Chikindas M.L.; Morozov G.I.; Mironov V.N.; Luk'yanov E.V.; Emel'yanov V.V.; Stepanov A.I., 1988: Regulatory regions of riboflavin biosynthesis operon from bacillus subtilis. Results are presented of the study of the regulatory regions of operon. Hybrid plasmid was constructed on the basis of pBR322 and included DNA fragment of Bacillus subtilis. The plasmid was used in the localization of ribosome binding fragment of...

Zhang, X.; Wu, Y.; Ji, S.; Guo, H.; Song, P.; Han, K.; Wu, W.; Wu, W.; James, T.D.; Zhao, J., 2010: Effect of the electron donor/acceptor orientation on the fluorescence transduction efficiency of the d-PET effect of carbazole-based fluorescent boronic acid sensors. We have synthesized three new carbazole-based fluorescent boronic acid sensors to investigate the fluorescence transduction efficiency of the novel d-PET effect, in which the fluorophore acts as the electron donor and the protonated amine/boronic...

Lakhani G.P.; Singh V.P.; Bhadoria S.S., 1990: Bacteriological qualities of raw milk obtained by machine versus hand milking in buffaloes. Standard plate count and coliform count were significantly higher in hand milking than machine milking at 0 hours, 4 hours and 8 hours of storage at room temperature, methylene blue reduction time test were significantly higher at 0 hours, 4 hours...

Cobb, S.R.; McCrossan, M.A., 1978: Study of foveal tritanopia. This paper discusses the possibility there is a difference between men and women in foveal tritanopia. The discussion is based on a study carried out by Cobb and McCrossan in 1973 in which they measured the luminosity curves of the fovea in five w...

Bonucci E.; D.M.rco A.; Nicoletti B.; Petrinelli P.; Pozzi L., 1975: Histologic and histochemical observations on mutant cn achondroplastic of the mouse as a possible model for human achondroplasia. Atti Associazione Genetica Italiana 20: 173-174

Saraswathy, R.; Suganya, S.; Singaram, P., 2007: Environmental impact of nitrogen fertilization in tea eco-system. To quantify the nitrogen losses through runoff, and leaching under a tea plantation in hilly soil, a field experiment was conducted from October 2001 to October 2002 at United Planters Association of Southern India (UPASI), Coonoor in Nilgiri dis...

Marini, G.; Ippoliti, G.; Casirola, G.; Vassallo, C., 1974: 2 cases of sepsis due to Pseudomonas aeruginosa. Minerva Medica 65(42): 2386-2389