Evaluating an optimal gastric closure method for transgastric surgery

Abstract

The prototype device decreases procedure time and yields leak-resistant gastrotomy closures that are superior to clips and rival hand-sewn interrupted stitches.

Organ Repair, Hemostasis, and In Vivo Bonding of Medical Devices by Aqueous Solutions of Nanoparticles

“…[ 1c , 6 ] However, tissue adhesives currently available in clinical practice present significant inherent limitations such as toxicity, insufficient strength, and/or excessive swelling. [ 1c , 6c , 7 ] Biomimetic approaches and new chemistries that yield polymer materials with adaptable adhesion strength are under development. [ 6b , e , 8 ] In practice, gluing or sealing with polymers remains a complex process: it requires both stringent storage and preparation conditions before in vivo glue application or in vivo initiation and control of chemical polymerization or cross-linking reactions.…”

Closure of Gastrotomy in Natural Orifice Transluminal Endoscopic Surgery: A Feasibility Study Using an Ex Vivo Model Comparing Endoloop With Endoclip

“…This is in contrast to the findings of Ryou et al who reported significantly low mean leak pressure of 33 mmHg. 12 In our study, a higher endoclip burst pressure could have resulted from closer placement of clips as on average we used 10 clips compared to Ryou's study using only 4-5 clips for closure. Our failed endoclip had given way at 15 mmHg; this was the result of a superficial bite of one edge by a central clip that was realized later at postmortem.…”

Peroral Dual Scope for Natural Orifice Transluminal Endoscopic Surgery (NOTES) Gastrotomy Closure

“…Although several methods of gastrotomy closure have been described in NOTES procedures to date, 1,[14][15][16][17][18][19] there has generally been a high incidence of postprocedure leakage from the incision site and limited follow-up. In our personal experience of more than 250 laboratory NOTES procedures, the gastric closure method that showed the greatest potential is the cardiac occluder being safe, rapid, and simple.…”