Experimental endoscopic repair of gastric perforations with an omental patch and clips.
BACKGROUND
The omental patch is a standard surgical treatment of gastroduodenal ulcer perforation. This is a report of an experimental method for endoscopic repair of anterior gastric perforations with an omental patch developed by using a porcine model.


METHODS
A standardized gastric perforation was created in 10 pigs. The omentum was pulled into the gastric lumen and fixed endoscopically to the muscularis propria layer of the stomach with metallic clips.


RESULTS
The postoperative course was normal in 9 animals. An ulcer was evident at the site of repair at follow-up endoscopy. At autopsy, the omentum was adherent to the external side of gastric wall. One animal died with peritonitis, presumably because the muscularis propria layer could not be seen during the procedure, and the clips attached the omentum only to the mucosa.


CONCLUSIONS
Endoscopic repair with an omental patch appears to be an effective procedure for closure of gastric perforations.
Hashiba
K
K
Faculdade de Medicina, Universidade Federal de Uberlândia Minas Gerais--Hospital Sírio Libanês, São Paulo, Brazil.
Carvalho
A M
AM
Diniz
G
G
Barbosa de Aridrade
N
N
Guedes
C A
CA
Siqueira Filho
L
L
Lima
C A
CA
Coehlo
H E
HE
de Oliveira
R A
RA
Carvaiho
A M
AM
Coetho
H E
HE
D000818:Animals; D004724:Endoscopy; D005773:Gastroscopy; D009852:Omentum / Q000601:surgery*; D010439:Peptic Ulcer Perforation / Q000601:surgery; D013270:Stomach / Q000293:injuries*; D013525:Surgical Instruments; D013552:Swine