Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model

被引:229
作者
Wagh, MS
Merrifield, BF
Thompson, CC
机构
[1] Brigham & Womens Hosp, Div Gastroenterol, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Boston, MA USA
关键词
D O I
10.1016/j.gie.2005.06.045
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background: Advances in endoscopic equipment have enabled endoluminal techniques to supplant select surgical procedures. Access to extraluminal structures holds the potential to revolutionize flexible endoscopy hut, to date, has been limited. The aim of this study was to demonstrate the feasibility of endoscopic transgastric organ resection (oophorectomy and tubectomy) with 2-week survival. Methods: Female Yorkshire pigs underwent general anesthesia, and a sterile esophageal overtube was placed. Antibacterial gastric lavage was performed, and a sterile gastroscope was passed through the overtube. Subsequently, a transgastric incision was made with a needle knife. The endoscope then was advanced into the peritoneal cavity, and the ovaries and the fallopian tubes were identified. An endoloop was used to secure the ovary, the fallopian tube, and the mesosalpinx. Snare cautery oophorectomy and tubectomy was performed, and the specimen was retrieved through the gastrotomy. The incision was closed with endoclips, and 2-week survival studies were performed. Observations: The peritoneal cavity was accessed in all animals (n = 6) without significant complications. The ovaries and the fallopian tubes were easily identified, and unilateral oophorectomy and tubectomy were successfully performed. Postoperative 2-week survival was uneventful in all animals. At necropsy, the gastric incision was seen as a well-healed scar with giant-cell reaction. There was histologic evidence of chronic inflammation at the resection site, without abscess, hematoma, adhesion, or damage to surrounding viscera. Conclusions: Endoscopic transgastric oophorectomy and tubectomy with 2-week survival is feasible with meticulous closure of the gastrotomy. This novel technique may extend the applications of flexible endoscopy to include aspects of abdominal surgery.
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页码:473 / 478
页数:6
相关论文
共 17 条
[1]  
CIPOLLETTA L, 1987, ITAL J GASTROENTEROL, V19, P23
[2]   Endoclip-assisted resection of large pedunculated colon polyps [J].
Cipolletta, L ;
Bianco, MA ;
Rotondano, G ;
Catalano, M ;
Prisco, A ;
De Simone, T .
GASTROINTESTINAL ENDOSCOPY, 1999, 50 (03) :405-407
[3]  
ENANDER LK, 1979, ACTA CHIR SCAND, V145, P575
[4]  
FAZIO RA, 1982, AM J GASTROENTEROL, V77, P556
[5]   COLONOSCOPIC APPENDECTOMY [J].
GAYLORD, SF .
GASTROINTESTINAL ENDOSCOPY, 1981, 27 (03) :203-203
[6]   Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity [J].
Kalloo, AN ;
Singh, VK ;
Jagannath, SB ;
Niiyama, H ;
Hill, SL ;
Vaughn, CA ;
Magee, CA ;
Kantsevoy, SV .
GASTROINTESTINAL ENDOSCOPY, 2004, 60 (01) :114-117
[7]  
Kuhry E, 2004, Semin Laparosc Surg, V11, P37, DOI 10.1177/107155170401100107
[8]  
MASS LC, 1978, JAMA-J AM MED ASSOC, V240, P248
[9]   Minilaparoscopic appendectomy [J].
Matthews, BD ;
Mostafa, G ;
Harold, KL ;
Kercher, KW ;
Reardon, PR ;
Heniford, BT .
SURGICAL LAPAROSCOPY ENDOSCOPY & PERCUTANEOUS TECHNIQUES, 2001, 11 (06) :351-355
[10]   Endoscopic partial hysterectomy in a porcine model using a novel per-oral transgastric approach [J].
Merrfield, BF ;
Wagh, MS ;
Thompson, CC .
AMERICAN JOURNAL OF GASTROENTEROLOGY, 2004, 99 (10) :S312-S313