title: Peroral transgastric endoscopic primary repair of a ventral hernia in a porcine model.
abstract: OBJECTIVE
  Multiple studies have demonstrated the feasibility of peroral transgastric endoscopic procedures in animal models. The aim of the study was to evaluate the feasibility of a peroral transgastric endoscopic approach to repair abdominal wall hernias.
  
  
  METHODS
  We performed acute experiments under general anesthesia with endotracheal intubation using 50-kg pigs. Following peroral intubation an incision of the gastric wall was made and the endoscope was advanced into the peritoneal cavity. An internal anterior abdominal wall incision was performed with a needle knife to create an animal model of a ventral hernia. After hernia creation an endoscopic suturing device was used for primary repair of the hernia. After completion of the hernia repair the endoscope was withdrawn into the stomach and the gastric wall incision was closed with endoscopic clips. Then the animals were killed for necropsy.
  
  
  RESULTS
  Two acute experiments were performed. Incision of the gastric wall was easily achieved with a needle knife and a pull-type sphincterotome. A large (3 x 2 cm) defect of the abdominal wall (ventral hernia model) was closed with five or six sutures using the endoscopic suturing device. Postmortem examination revealed complete closure of the hernia without any complications.
  
  
  CONCLUSIONS
  Transgastric endoscopic primary repair of ventral hernias in a porcine model is feasible and may be technically simpler than laparoscopic surgery.
authors.affiliation: Eastern Hepatobiliary Hospital, Second Military Medical University of PLA, Shanghai, Ch.
authors.forename: B
authors.initials: B
authors.lastname: Hu
authors.forename: A N
authors.initials: AN
authors.lastname: Kalloo
authors.forename: S S C
authors.initials: SS
authors.lastname: Chung
authors.forename: P B
authors.initials: PB
authors.lastname: Cotton
authors.forename: C J
authors.initials: CJ
authors.lastname: Gostout
authors.forename: R H
authors.initials: RH
authors.lastname: Hawes
authors.forename: P J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: N V
authors.initials: NV
authors.lastname: Isakovich
authors.forename: Y
authors.initials: Y
authors.lastname: Nakajima
authors.forename: K
authors.initials: K
authors.lastname: Kawashima
authors.forename: S V
authors.initials: SV
authors.lastname: Kantsevoy
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D016145:Endoscopy, Digestive System / Q000379:methods*; D005240:Feasibility Studies; D046449:Hernia, Abdominal / Q000601:surgery*; D007440:Intubation / Q000379:methods; D013552:Swine