title: Totally stapled gastrojejunal anastomosis using hybrid NOTES: single 12-mm trocar approach in a porcine model.
abstract: BACKGROUND
  The aim of this study was to evaluate the feasibility of a totally stapled gastrojejunal anastomosis performed using one transabdominal 12-mm trocar and a gastroscope in a porcine model.
  
  
  METHODS
  The procedure was carried out on six domestic pigs weighing 45 kg using a hybrid technique with a gastroscope and a 12-mm Hasson trocar, positioned in the left hypochondrium. At the end of the procedure a mechanical circular 21-mm gastrojejunal anastomosis was performed by inserting the stapler through a small gastrotomy after enlarging the trocar incision.
  
  
  RESULTS
  In all six cases the procedure was completed through a single 3 cm abdominal incision and without complications. The mean operating time was 2 h, and endoscopic investigation showed that the anastomoses were intact, patent, and airtight.
  
  
  CONCLUSIONS
  Totally stapled gastrojejunal anastomosis using a hybrid NOTES-single 12-mm trocar approach is a feasible procedure in the porcine model. Further survival studies are warranted, particularly to evaluate the functional results of this procedure.
authors.affiliation: Department of Surgical and Gastroenterological Sciences, University of Padova, Padua, Italy. linopolese@hotmail.com
authors.forename: Lino
authors.initials: L
authors.lastname: Polese
authors.forename: Stefano
authors.initials: S
authors.lastname: Merigliano
authors.forename: Benedetto
authors.initials: B
authors.lastname: Mungo
authors.forename: Roberto
authors.initials: R
authors.lastname: Rizzato
authors.forename: Roberto
authors.initials: R
authors.lastname: Luisetto
authors.forename: Ermanno
authors.initials: E
authors.lastname: Ancona
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Norberto
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods; D000818:Animals; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D020699:Gastroscopes; D007583:Jejunum / Q000601:surgery*; D023421:Models, Animal; D057605:Natural Orifice Endoscopic Surgery / Q000295:instrumentation*; D013270:Stomach / Q000601:surgery*; D017792:Surgical Stapling; D013552:Swine