Transgastric small bowel resection by using hybrid technique — Experimental study

K. Shanava; Sz. Horváth; F. Karl-Hermann; Sz. Jávor; I. Takács; B. Balatonyi; S. Ferencz; A. Ferencz; E. Rőth; György Wéber

doi:10.1556/imas.2.2010.3.7

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Interventional Medicine and Applied Science

Volume/Issue:: Volume 2: Issue 3

Transgastric small bowel resection by using hybrid technique — Experimental study

Authors:

K. Shanava

K. Shanava Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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Sz. Horváth

Sz. Horváth Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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F. Karl-Hermann

F. Karl-Hermann Department of Surgery, Markus Krankenhaus, Frankfurt am Main, Germany

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Sz. Jávor

Sz. Jávor Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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I. Takács

I. Takács Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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B. Balatonyi

B. Balatonyi Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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S. Ferencz

S. Ferencz Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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A. Ferencz

A. Ferencz Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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E. Rőth

E. Rőth Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary

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, and

György Wéber

György Wéber Department of Surgical Research and Techniques, Medical Faculty, University of Pécs, Pécs, Hungary
Kodály Z. u. 20, H-7624, Pécs, Hungary

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Pages:: 126–130

Online Publication Date:: 01 Sep 2010

Publication Date:: 01 Sep 2010

Article Category:: Research Article

DOI:: https://doi.org/10.1556/imas.2.2010.3.7

Keywords:: NOTES; hybrid technique; transgastric; small bowel resection

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Abstract

Introduction:The Natural Orifice Transluminal Endoscopic Surgery (NOTES) is an abdominal operation carried out with flexible endoscopic instruments and their advanced versions via natural orifices. The NOTES causes theoretically less pain, operative stress, shorter hospitalization, quicker recovery and it is scarless. The aim of this investigation was to evaluate the feasibility and safety of transgastric small bowel resection. Materials and methods: Seven domestic pigs were investigated and entered the study; body weight 25 kg in average. General anesthesia was performed. One trocar was used for laparoscopic observations during gastrotomy and transgastric penetration with the gastroscope, later for assistance with a grasper for manipulation of the bowel loops and for the application of the linear stapling device. Then the needle knife was used to complete a 1.5 cm long incision in the gastric wall. The gastroscope was advanced into the peritoneal cavity and a small bowel loop was identified and elevated with a flexible grasper. Through the second channel of the scope a coag grasper was used to dissect the mesentery. Then a linear stapler was inserted through the assisting trocar and the resection was performed. Afterwards the bowel ends were opened with the needle knife and the stapler was reinserted for a side-to-side anastomosis. The specimen was removed via the stomach. Gastric closure was completed by laparoscopic mini-instruments through the stapler-port. All special events and all problems were prospectively documented. Follow-up was performed over 2 weeks and body weight was recorded. Then a laparoscopy was performed to document adhesions or abscess formation. Finally the animals were sacrificed to evaluate further evidence of infection or adhesions. Results: The operations were carried without complications, there was no case of letal outcome. On the 12th day the abdominal laparoscopic revision was carried out, after the revision in one case adhesion could be detected, no other kinds of complications were noticed. Conclusion: According to our results, the transgastric small bowel resection is a safe procedure, but further special instruments are needed. These experimental procedures should be evaluated carefully and critically in clinical practice.

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Interventional Medicine and Applied Science

Print ISSN:: 2061-1617

Online ISSN:: 2061-5094

2019
Scimago H-index	11
Scimago Journal Rank	0,220
Scimago Quartile Score	Medicine (miscellaneous) Q3
Scopus Cite Score	155/133=1,2
Scopus Cite Score Rank	General Medicine 199/529 (Q2)
Scopus SNIP	0,343
Scopus Cites	206
Scopus Documents	23

Interventional Medicine and Applied Science
Language	English
Size
Year of Foundation	2009
Publication Programme	changed title
Volumes per Year
Issues per Year
Founder	Akadémiai Kiadó
Founder's Address	H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher	Akadémiai Kiadó
Publisher's Address	H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible Publisher	Chief Executive Officer, Akadémiai Kiadó
ISSN	2061-1617 (Print)
ISSN	2061-5094 (Online)