title: Gastrotomy closure with a new tissue anchoring device: a porcine survival study.
abstract: OBJECTIVE
  To evaluate the feasibility, reproducibility and efficacy of a new tissue anchoring device in a porcine survival model.
  
  
  METHODS
  Gastrotomies were performed using a needle-knife and balloon dilator in 10 female Yorkshire pigs weighing 30-35 kg. Gastric closure was attempted using a new tissue anchoring device. The tightness of the closure was confirmed by means of air insufflation and the ability to maintain gastric distension with stability in peritoneal pressure measured with a Veress needle. All animals were monitored daily for signs of peritonitis and sepsis over 14 d. During necropsy, the peritoneal cavity and the gastric access site were examined.
  
  
  RESULTS
  Transgastric access, closure and 14 d survival was achieved in all pigs. The mean closure time was 18.1 ± 19.2 min and a mean of 2.1 ± 1 devices were used. Supplementary clips were necessary in 2 cases. The closure time was progressively reduced (24.8 ± 13.9 min in the first 5 pigs vs 11.4 ± 5.9 min in the last 5, P = NS). At necropsy, the gastric access site was correctly closed in all cases with all brace-bars present. One device was misplaced in the mesocolon. Minimal adhesions were observed in 3 pigs and signs of mild peritonitis and adhesions in one.
  
  
  CONCLUSIONS
  The use of this new tissue anchoring device in porcine stomachs is feasible, reproducible and effective and requires a short learning curve.
authors.affiliation: Endoscopy Unit, Hospital Clínic, CIBERehd, Barcelona 08026, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Guarner-Argente
authors.forename: Henry
authors.initials: H
authors.lastname: Córdova
authors.forename: Graciela
authors.initials: G
authors.lastname: Martínez-Pallí
authors.forename: Ricard
authors.initials: R
authors.lastname: Navarro-Ripoll
authors.forename: Antonio
authors.initials: A
authors.lastname: Rodríguez-d'Jesús
authors.forename: Cristina Rodríguez
authors.initials: CR
authors.lastname: de Miguel
authors.forename: Mireia
authors.initials: M
authors.lastname: Beltrán
authors.forename: Gloria
authors.initials: G
authors.lastname: Fernández-Esparrach
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004867:Equipment Design; D005260:Female; D005774:Gastrostomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D015996:Survival Rate; D013536:Suture Techniques / Q000295:instrumentation*; D013552:Swine