Feasibility of thoracoscopic U-clip esophageal anastomosis: an alternative for esophageal atresia reconstruction.
BACKGROUND
The authors propose that U-Clips can significantly decrease the technical difficulty of performing thoracoscopic esophageal reconstruction, thus, reducing operating time, the incidence of postoperative leak, and stricture rate.


METHODS
After obtaining Institutional Animal Care and Use Committee approval, 3 4-kg female piglets underwent complete thoracoscopic esophageal transections. The esophagus was reconstructed thoracoscopically using S50 and S60 U-Clips over an 8F transanastomotic tube. Esophagrams were performed on postoperative day (POD) 7, 21, 44, and 77.


RESULTS
Mean operating time was 57 minutes (45 to 75 min). Two of 3 piglets had no evidence of leak on POD 7 esophagrams. One animal had a small leak that resolved spontaneously on antibiotics. All 3 piglets tolerated a formula diet orally by POD 8. Over a 77-day survival period all 3 piglets had steady weight gain on an oral diet.


CONCLUSIONS
U-Clips are a feasible alternative to sutures for esophageal reconstruction in thoracoscopic surgery. Further study is warranted to investigate the full potential of U-Clips in minimally invasive pediatric surgery.
Tirabassi
Michael V
MV
Division of Pediatric Surgery, Baystate Medical Center Children's Hospital, Tufts University School of Medicine, UMASS Baystate Medical Center Biosciences Initiative, Springfield, MA, USA.
Banever
Gregory T
GT
Moriarty
Kevin P
KP
Konefal
Stanley
S
Reiter
Edward
E
Wait
Richard
R
D000714:Anastomosis, Surgical / Q000295:instrumentation; D000818:Animals; D004195:Disease Models, Animal; D004933:Esophageal Atresia / Q000601:surgery*; D004944:Esophagoplasty / Q000295:instrumentation*; D004947:Esophagus / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D019060:Minimally Invasive Surgical Procedures; D034421:Sus scrofa; D013906:Thoracoscopy / Q000379:methods*