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

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.