title: Endoscopic closure of a tracheal access site using bioglue after transtracheal thoracoscopy in a nonsurvival canine model.
abstract: OBJECTIVE
  An ideal wound closure device would repair the wound with minimal complexity. In this report, we describe a simple wound closure method using BioGlue sealant.
  
  
  METHODS
  Eleven canines underwent transtracheal pericardial window creation under endoscopic guidance for natural orifice transluminal endoscopic surgery (NOTES). The tracheal wound was closed using BioGlue sealant. The integrity of the wound was assessed by determining the amount of air leaking under mechanical ventilation.
  
  
  RESULTS
  Transtracheal thoracic exploration and pericardial window creation was successful for all of the canines, and adequate wound closure was achieved in 10 of the canines. There was 1 case of NOTES-related death arising from misplacement of the endotracheal tube in the left lower lobar bronchus. This caused a collapse of the left upper lobe and ventilatory failure. Minor lung injuries occurred in 3 canines and minor mediastinal bleeding was encountered in 1 canine during the creation of the access site.
  
  
  CONCLUSIONS
  BioGlue sealant was found to be effective in sealing the tracheal wound in all but 1 of the canines. This study demonstrates that the use of the sealant is a simple and efficient means of endoscopically closing the tracheal access site in NOTES.
authors.affiliation: Laboratory Animal Center, Department of Surgery, Chang Gung Memorial Hospital, Linko, Chang Gung University, Guei-Shan Shiang, Taiwan, ROC.
authors.forename: W-H
authors.initials: WH
authors.lastname: Chen
authors.forename: Y
authors.initials: Y
authors.lastname: Chu
authors.forename: Y-C
authors.initials: YC
authors.lastname: Wu
authors.forename: C-Y
authors.initials: CY
authors.lastname: Liu
authors.forename: H-C
authors.initials: HC
authors.lastname: Yuan
authors.forename: P-J
authors.initials: PJ
authors.lastname: Ko
authors.forename: Y-H
authors.initials: YH
authors.lastname: Liu
mesh_terms: D000818:Animals; D004285:Dogs; D004724:Endoscopy; D023421:Models, Animal; D057605:Natural Orifice Endoscopic Surgery; D010491:Pericardial Window Techniques; D011506:Proteins / Q000008:administration & dosage*; D013906:Thoracoscopy; D014014:Tissue Adhesives / Q000008:administration & dosage*; D014132:Trachea / Q000601:surgery*; D014947:Wounds and Injuries / Q000601:surgery*
chemical_list: C472676:Bio-glue; D011506:Proteins; D014014:Tissue Adhesives