title: Full-thickness laparoendoscopic excision in the stomach: the FLEx technique.
abstract: BACKGROUND
  The authors describe the initial validation of a novel full-thickness laparoendoscopic excision (FLEx) technique for the stomach.
  
  
  METHODS
  The technique was studied in seven 50-kg pigs. Secure full-thickness excision was ensured by inversion excision target with a 1-cm circumferential margin using laparoendoscopically placed brace bars passed intraluminally from the outside of the stomach, laparoscopic oversewing of the site of inversion, and endoscopic full-thickness excision using a dual scope approach. Pigs were sacrificed either immediately (n = 3) or between 7 and 10 days after surgery (n = 4).
  
  
  RESULTS
  The procedure achieved uncomplicated full-thickness excision in every case. Median procedure duration was 227 minutes (range = 210-245 minutes). Median specimen diameter was 5.5 cm (range = 2.5-8 cm). Investigative autopsy confirmed technical sufficiency in all animals. Median site bursting pressure was 130 mm Hg (range = 120-160 mm Hg).
  
  
  CONCLUSIONS
  The FLEx technique proved useful for excision of small localized lesions of the stomach in this animal study.
authors.affiliation: Department of Surgery, St Mark's Hospital, Harrow, UK. Robin.Kennedy@nwlh.nhs.uk
authors.forename: Robin H
authors.initials: RH
authors.lastname: Kennedy
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Cahill
authors.forename: Adela
authors.initials: A
authors.lastname: Brigic
authors.forename: Paul
authors.initials: P
authors.lastname: Sibbons
authors.forename: Chris
authors.initials: C
authors.lastname: Fraser
mesh_terms: D000818:Animals; D005240:Feasibility Studies; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D023421:Models, Animal; D013270:Stomach / Q000601:surgery*; D013552:Swine; D013997:Time Factors