title: Novel technique for full-thickness resection of gastric malignancy: feasibility of nonexposed endoscopic wall-inversion surgery (news) in porcine models.
abstract: Full-thickness resection for gastric malignancy carries a risk of peritoneal dissemination due to opening of the gastric lumen. We evaluated the feasibility and safety a novel method of full-thickness resection without transmural communication, called nonexposed endoscopic wall-inversion surgery in ex vivo and in vivo porcine models. Six explanted porcine stomachs and 6 live pigs were used for this study. After marking and submucosal injection around 3 cm simulated lesions, the seromuscular layer was laparoscopically cut and sutured with the lesion inverted to the inside. Consecutively, a mucosubmucosal incision was made endoscopically. Three pigs used for the survival study were monitored for 7 days. All 12 lesions were successfully resected en bloc without perforation. The 3 pigs survived for 1 week without adverse events, and necropsy revealed neither leakage nor abscess formation related to the operation. We demonstrated nonexposed endoscopic wall-inversion surgery to be technically feasible and safe in both ex vivo and in vivo porcine studies.
authors.affiliation: Departments of *Gastrointestinal Surgery †Gastroenterology ‡Endoscopy and Endoscopic Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Mitsui
authors.forename: Osamu
authors.initials: O
authors.lastname: Goto
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Shimizu
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Hatao
authors.forename: Ikuo
authors.initials: I
authors.lastname: Wada
authors.forename: Keiko
authors.initials: K
authors.lastname: Niimi
authors.forename: Itsuko
authors.initials: I
authors.lastname: Asada-Hirayama
authors.forename: Mitsuihiro
authors.initials: M
authors.lastname: Fujishiro
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Seto
mesh_terms: D000818:Animals; D005240:Feasibility Studies; D005773:Gastroscopy / Q000379:methods*; D010534:Peritoneal Neoplasms / Q000517:prevention & control / Q000556:secondary; D013274:Stomach Neoplasms / Q000601:surgery*; D013552:Swine