A novel endolaparoscopic intragastric partitioning for treatment of morbid obesity.
Morbid obesity is a burgeoning health crisis. Significant morbidity is associated with the current gastric bypass, and, therefore, alternative surgical modalities are desired. A novel minimally invasive surgical technique, endoluminal gastric partitioning, is presented. Ten mongrel dogs underwent endolaparoscopic placement of intragastric mesh. Each circular prosthesis (Surgisis or prolene mesh) was 8 cm in diameter with a 1.5 cm central aperture. The mesh was passed transorally into the gastric lumen and secured with a laparoscopic, intragastric suturing resulting in a 30 to 50 mL proximal gastric reservoir. The operation was successfully completed in all 10 animals. Nine of 10 animals were healthy at the scheduled sacrifice date. In 2 dogs, the intragastric mesh was 100% adherent to the gastric mucosa after 7 days. Four of the final 5 dogs demonstrated some degree of mucosal adherence after 1 week. Endoluminal placement of intragastric mesh appears feasible and safe. Long-term studies are necessary to demonstrate the efficacy and long-term weight loss of this, or alternate intraluminal gastric partitioning techniques.
Felsher
Joshua
J
Department of General Surgery, Minimally Invasive Surgery Center, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Rosen
Michael
M
Farres
Houssam
H
Walsh
R Matthew
RM
D000818:Animals; D004285:Dogs; D004724:Endoscopy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D010535:Laparoscopy / Q000379:methods; D009767:Obesity, Morbid / Q000601:surgery*; D013526:Surgical Mesh; D013536:Suture Techniques