Laparoscopic modified Sugiura procedure: experimental study on the pig.
BACKGROUND
The Sugiura procedure is an alternative treatment for bleeding gastroesophageal varices. Laparoscopic Sugiura procedure has not previously been described. The aim of this study is to develop a laparoscopic oesophageal transection with an EEA stapler, as well as a complete laparoscopic modified Sugiura procedure.


METHODS
We used six female farm pigs weighing 40-50 kg. Six trocars were used. The steps of the procedure are: 1) mobilization of the lower oesophagus and truncal vagotomy; 2) oesophageal resection-anastomosis with an EEA stapler; 3) devascularization of the corpus and fundus of the stomach and the lower 10 cm of the oesophagus; 4) splenectomy; 5) Nissen fundoplication; 6) pyloroplasty.


RESULTS
The mean operation time was 180 min, while the mean blood loss 260 ml. All staple lines are integral during autopsy at the end of the procedure.


CONCLUSIONS
Laparoscopic oesophageal transection with an EEA stapler as well as a complete laparoscopic modified Sugiura procedure are feasible.
Tsimoyiannis
E C
EC
Department of Surgery, G. Hatzikosta General Hospital, Ioannina, Greece.
Siakas
P
P
Tassis
A
A
Glantzounis
G
G
Gogos
C
C
Mousafiri
U
U
D000818:Animals; D016063:Blood Loss, Surgical; D004932:Esophageal and Gastric Varices / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D018662:Fundoplication; D006471:Gastrointestinal Hemorrhage / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D011708:Pylorus / Q000601:surgery; D013156:Splenectomy; D013528:Surgical Staplers; D013552:Swine; D015167:Vagotomy, Truncal