A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model

• Published in: Gastrointestinal endoscopy 2007-10, Vol.66 (4), p.809-813
• Main Authors: Perretta, Silvana, MD, Sereno, Stefano, MD, Forgione, Antonello, MD, Dallemagne, Bernard, MD, Coumaros, Dimitri, MD, Boosfeld, Cristoph, PhD, Moll, Clemens, Marescaux, Jacques, MD
• Format: Article
• Language: English
• Subjects: Alloys; Animals; Biological and medical sciences; Digestive system. Abdomen; Disease Models, Animal; Endoscopy; Equipment Design; Feasibility Studies; Follow-Up Studies; Gastroenterology and Hepatology; Gastroscopes; Gastroscopy - methods; Gastroscopy - mortality; Heart Septum; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Prosthesis Design; Prosthesis Implantation - instrumentation; Prosthesis Implantation - mortality; Stents; Stomach - surgery; Survival Analysis; Swine; Time Factors; Treatment Outcome
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/j.gie.2007.05.055

Introduction Closure of the gastrotomy when performing transgastric procedures is one of the most challenging steps to overcome. Several methods of gastric closure have been described, but a simple and safe technique is still lacking. Aim To evaluate the technical feasibility and safety of a new method of endoscopic gastric closure using a nitinol septal occluder in a porcine survival model. Design Endoscopic animal experimental study in a porcine survival model. Materials and Methods In 6 male pigs under general anesthesia, a 1-cm full-thickness gastrotomy was performed on the anterior body of the stomach and closed with a nitinol septal occluder (Occlutech). Postoperative follow-up included endoscopy and laparoscopy at 1, 2, 4, and 6 weeks after the initial procedure and endoscopy alone at weeks 8, 10, and 12. Results All of the gastrotomy closures with the septal occluder were successful. At follow-up endoscopy and laparoscopy there were no signs of adhesions, peritonitis, or perigastric abscess formation at the gastrotomy site. At 12 weeks, 5 of 6 animals were thriving, with appropriate weight gain. Conclusions Endoscopic gastrotomy closure with a septal occluder is technically feasible, safe, and effective in a survival porcine model.