Endoluminal suturing may overcome the limitations of clip closure of a gaping wide colon perforation (with videos)

Raju, Gottumukkala S.; Shibukawa, Goro; Ahmed, Ijaz; Brining, Douglas; Poussard, Allison; Xiao, Shu Yuan; Coe, Jonathan; Cropper, Mike; Martin, Dave; Hull, Joanne

doi:10.1016/j.gie.2006.08.048

Cited by 73 publications

(56 citation statements)

References 16 publications

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“…There are no safe and effective systems for performing such closure endoscopically, even though various systems have been described, involving anchor points, forceps combined with a suturing needle, an endoscopic stapler, and a system using multiple clips [10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Hybrid transvaginal cholecystectomy, NOTES, and minilaparoscopy: analysis of a prospective clinical series

et al. 2009

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Hybrid transvaginal cholecystectomy is a good surgical model for minimally invasive surgery, a combination of NOTES and minilaparoscopy. It can be performed in surgical settings where laparoscopy is practised regularly, using the instruments normally used for endoscopy and laparoscopic surgery. Owing to the reproducibility of the intervention and the ease of vaginal closure, hybrid transvaginal cholecystectomy will permit further development of NOTES in the future.

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Section: Discussionmentioning

confidence: 99%

Hybrid transvaginal cholecystectomy, NOTES, and minilaparoscopy: analysis of a prospective clinical series

et al. 2009

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“…Currently, three types of fullthickness suture devices are under evaluation for perforation closure of stomach and colon: two through-theendoscope devices such as the endoscopic suturing kit (Tfasteners with a locking cinch) and the gProx (USGI Medical, San Clemente, CA, USA), and one over-theendoscope device, the Eagle Claw Suturing Device (Apollo Group and the Olympus Medical Systems, Tokyo, Japan) [11]. The endoscopic suturing kit has been used successfully in different gastrointestinal procedures (perforations after endoluminal gastric or colon resections, transgastric gastrojejunostomy and pyloroplasty, closure of perforated gastric ulcer) both in animals and humans [12][13][14][15][16][17]. Because this method uses equipment that works through a 2.8-mm channel of a standard gastroscope, we hypothesized that we could apply it through a 7F working channel of a cystoscope.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Closure of Transmural Bladder Wall Perforations

et al. 2009

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Background: Traditionally, intraperitoneal bladder perforations caused by trauma or iatrogenic interventions have been treated by open or laparoscopic surgery. Additionally, transvesical access to the peritoneal cavity has been reported to be feasible and useful for natural orifice translumenal endoscopic surgery (NOTES) but would be enhanced by a reliable method of closing the vesicotomy. Objective: To assess the feasibility and safety of an endoscopic closure method for vesical perforations using a flexible, small-diameter endoscopic suturing kit in a survival porcine model. Design, setting, and participants: This pilot study was performed at the University of Minho, Braga, Portugal, using six anesthetized female pigs. Interventions: Closure of a full-thickness longitudinal incision in the bladder dome (up to 10 mm in four animals and up to 20 mm in two animals) with the endoscopic suturing kit using one to three absorbable stitches. Measurements: The acute quality of sealing was immediately tested by distending the bladder with methylene-blue dye under laparoscopic control (in two animals). Without a bladder catheter, the animals were monitored daily for 2 wk, and a necropsy examination was performed to check for the signs of peritonitis, wound dehiscence, and quality of healing. Results and limitations: Endoscopic closure of bladder perforation was carried out easily and quickly in all animals. The laparoscopic view revealed no acute leak of methylene-blue dye after distension of the bladder. After recovery from anaesthesia, the pigs began to void normally, and no adverse event occurred. Postmortem examination revealed complete healing of vesical incision with no signs of infection or adhesions in the peritoneal cavity. No limitations have yet been studied clinically. Conclusions: This study demonstrates the feasibility and the safety of endoscopic closure of vesical perforations with an endoscopic suturing kit in a survival porcine model. This study provides support for further studies using endoscopic closure of the bladder which may lead to a new era in management of bladder rupture and adoption of the transvesical port in NOTES procedures.

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“…Others have demonstrated that without laparoscopic control, TAS colotomy closures can be safely performed. 21 Developers of the TAS system recommend laparoscopic visualization during deployment of the T-tags. We used a pure NOTES approach in our experiment without the use of a laparoscope, and we were able to place T-tags accurately and in a controlled fashion.…”

Section: Discussionmentioning

confidence: 99%

“…The Canadian Surgery FORUM canadien de chirurgie will hold its annual meeting Sept. [19][20][21][22]2013, in Calgary, Alberta. This interdisciplinary meeting provides an opportunity for surgeons across Canada with shared interests in clinical practice, continuing professional development, research and medical education to meet in a collegial fashion.…”

Section: Canadian Surgery Forummentioning

confidence: 99%

NOTES for the management of an intra-abdominal abscess: transcolonic peritonoscopy and abscess drainage in a canine model

Moustarah

Talarico²,

Zinc³

et al. 2013

Can J Surg

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Background:We studied natural orifice transcolonic drainage of intra-abdominal abscesses in a canine survival model to evaluate the difficulty of peritonoscopy and abscess drainage and the reliability of endoluminal colotomy closure. Methods:We placed a 7 cm nonsterile saline-filled latex balloon intra-abdominally to mimic or induce an abscess or inflammatory mass. Seven days later, we advanced a single-channel endoscope transanally into the sigmoid colon of the animal, made a colotomy and then advanced the endoscope intraperitoneally. We evacuated the identified abscess and placed a drain transabdominally. We closed the colotomy endoluminally with a tissue approximation system using 2 polypropylene sutures attached to metal T-bars. Two weeks later, we evaluated the colotomy closure at laparotomy. Results:We studied 12 dogs: 8 had subphrenic balloon implants and 4 had interbowel loop implants. Eleven survived and underwent transcolonic peritonoscopy; we identified the "abscess" in 9. The colotomy was successfully closed in 10 of 11 dogs. Although abscesses were easily identified, the overall difficulty of the peritonoscopy was moderate to severe. One dog required colotomy closure via laparotomy, while 9 had successful endoluminal closure. After colotomy closure, 8 animals survived for 2 weeks (study end point) without surgical complications, sepsis or localized abdominal infections. On postmortem examination, all closures were intact without any adjacent organ damage or procedure-related complications. Conclusion:Natural orifice transluminal endoscopic surgery provides a novel alternative to treating intra-abdominal pathology. It is technically feasible to perform endoscopic transcolonic peritonoscopy and drainage of an intra-abdominal abscess with reliable closure of the colotomy in a canine experimental model. Contexte :Nous avons étudié le drainage transcolique par voie naturelle d'abcès intraabdominaux dans un modèle canin de survie afin d'évaluer la difficulté de la péritono-scopie et du drainage des abcès, ainsi que la fiabilité de la fermeture endoluminale de la colotomie.

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Endoluminal suturing may overcome the limitations of clip closure of a gaping wide colon perforation (with videos)

Cited by 73 publications

References 16 publications

Hybrid transvaginal cholecystectomy, NOTES, and minilaparoscopy: analysis of a prospective clinical series

Hybrid transvaginal cholecystectomy, NOTES, and minilaparoscopy: analysis of a prospective clinical series

Endoscopic Closure of Transmural Bladder Wall Perforations

NOTES for the management of an intra-abdominal abscess: transcolonic peritonoscopy and abscess drainage in a canine model

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