A new method to close the gastrotomy by using a cardiac septal occluder: long-term survival study in a porcine model.
BACKGROUND
Closure of the gastrotomy when performing transgastric procedures is one of the most challenging steps to overcome. Several methods of gastric closure have been described, but a simple and safe technique is still lacking.


OBJECTIVE
To evaluate the technical feasibility and safety of a new method of endoscopic gastric closure using a nitinol septal occluder in a porcine survival model.


METHODS
Endoscopic animal experimental study in a porcine survival model.


METHODS
In 6 male pigs under general anesthesia, a 1-cm full-thickness gastrotomy was performed on the anterior body of the stomach and closed with a nitinol septal occluder (Occlutech). Postoperative follow-up included endoscopy and laparoscopy at 1, 2, 4, and 6 weeks after the initial procedure and endoscopy alone at weeks 8, 10, and 12.


RESULTS
All of the gastrotomy closures with the septal occluder were successful. At follow-up endoscopy and laparoscopy there were no signs of adhesions, peritonitis, or perigastric abscess formation at the gastrotomy site. At 12 weeks, 5 of 6 animals were thriving, with appropriate weight gain.


CONCLUSIONS
Endoscopic gastrotomy closure with a septal occluder is technically feasible, safe, and effective in a survival porcine model.
Perretta
Silvana
S
Institut de Recherche contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery, University of Strasbourg, Strasbourg, France.
Sereno
Stefano
S
Forgione
Antonello
A
Dallemagne
Bernard
B
Coumaros
Dimitri
D
Boosfeld
Cristoph
C
Moll
Clemens
C
Marescaux
Jacques
J
D000497:Alloys; D000818:Animals; D004195:Disease Models, Animal; D004867:Equipment Design; D005240:Feasibility Studies; D005500:Follow-Up Studies; D020699:Gastroscopes; D005773:Gastroscopy / Q000379:methods* / Q000401:mortality; D006346:Heart Septum; D008297:Male; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000295:instrumentation* / Q000401:mortality; D015607:Stents; D013270:Stomach / Q000601:surgery*; D016019:Survival Analysis; D013552:Swine; D013997:Time Factors; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol