Endoscopic full-thickness resection of the stomach

Kaehler, Georg; Langner, Cord; Suchan, K. L.; Freudenberg, S.; Post, Stefan

doi:10.1007/s00464-005-0147-0

Cited by 33 publications

(17 citation statements)

References 8 publications

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“…Most of these techniques are limited with regards to safety and reproducibility, are technically challenging, and require complex or specialized equipment [1,5,7,11,[23][24][25][26][27][28][29][30][31][32][33]. Moreover, a secure and reliable closure technique is of fundamental importance before these procedures can be introduced into the clinical arena.…”

Section: Discussionmentioning

confidence: 98%

Endoscopic Full-Thickness Resection of Submucosal Gastric Tumors

et al. 2012

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Section: Discussionmentioning

confidence: 98%

Endoscopic Full-Thickness Resection of Submucosal Gastric Tumors

et al. 2012

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“…There have been some previous studies of EFTR without transmural communication [14][15][16]. In these techniques, a pseudopolyp is first created by using a grasping or lifting device, and fixed with or without an endoloop, and finally resected with an electrocautery snare or specialized equipment such as a flexible stapling device.…”

Section: Discussionmentioning

confidence: 99%

New method of endoscopic full-thickness resection: a pilot study of non-exposed endoscopic wall-inversion surgery in an ex vivo porcine model

et al. 2011

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The indications for endoscopic full-thickness resection (EFTR) are limited because transmural communication during the entire procedure, causing tumor dissemination into the abdominal space, is inevitable. We invented a new method of EFTR without transmural communication, and explored its feasibility in an ex vivo porcine model. Three explanted porcine stomachs were used. First, markings around a model lesion were made with a flexible endoscope, and 0.9% normal saline with indigocarmine was injected into the submucosa around the markings. Second, a circumferential sero-muscular incision was made from the outside with an electrocautery knife, guided by the color of the submucosal injection and intragastric navigation with the endoscope. Third, the muscle layer was linearly sutured with the lesion inverted into the inside. Finally, a circumferential muco-submucosal incision was made with an electrocautery knife employed with the endoscope. The method was performed for 3 lesions (1 anterior wall, 1 lesser curve, and 1 posterior wall of the gastric body), and all lesions were successfully resected in en-bloc fashion. The mean size of the resected specimen was 4.5 cm in diameter. Neither perforation nor apparent air leakage was seen during or after the resection. Non-exposed endoscopic wall-inversion surgery (NEWS) is thought to be effective as a minimally invasive, and minimal-size endoluminal surgery for gastric submucosal tumors with or without ulceration, or even node-negative early gastric cancer that is difficult to resect by endoscopic submucosal dissection.

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“…Transgastric usage of SurgAssist TM Power medical stapler has been described in the literature in ex vivo porcine and human models [10] and in in vivo porcine stomach [11]. A recent human case report [12] described fullthickness gastric resection for adenocarcinoma and carcinoid tumors.…”

Section: Discussionmentioning

confidence: 99%