CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(04): E440-E445
DOI: 10.1055/a-0658-1283
Original article
Owner and Copyright © Georg Thieme Verlag KG 2019

An innovative laparoscopic and endoscopic technique in an animal model: combined gastric full-thickness tumor resection

Flavio Hiroshi Ananias Morita
University of São Paulo Medical School - Gastroenterology Department, Sao Paulo, Brazil
,
Christiano Makoto Sakai
University of São Paulo Medical School - Gastroenterology Department, Sao Paulo, Brazil
,
Flavio Masato Kawamoto
University of São Paulo Medical School - Gastroenterology Department, Sao Paulo, Brazil
,
Eduardo Guimarães Hourneaux de Moura
University of São Paulo Medical School - Gastroenterology Department, Sao Paulo, Brazil
,
Paulo Sakai
University of São Paulo Medical School - Gastroenterology Department, Sao Paulo, Brazil
› Author Affiliations
Further Information

Publication History

submitted 05 February 2018

accepted after revision 30 May 2018

Publication Date:
21 March 2019 (online)

Abstract

Background and study aims The combination of endoscopy with laparoscopy for full-thickness gastric resection has received much attention. The advantage in using it is removak of the target lesion without resection of excessive normal tissue. The technique could prevent deformed scars, particularly at the cardia and in the prepyloric area. The aim of this protocol was to evaluate a new combined operation for full-thickness resection of the gastric wall.

Materials and methods Gastric subepithelial lesions in multiple topographic locations of the stomach were simulated in seven live pigs. Full-thickness gastric resection was undertaken and after assessment of the outcome, the animals were euthanized. The primary endpoint was accomplishment of the procedure following all steps in the new technique, in various gastric locations. The secondary endpoints were duration of the procedure, quality of specimen margins, and complications.

Results Resections were successful, complete, and complication-free, ensuring a safe surgical margin of healthy tissue. The procedure was completed in 50 minutes. No mucosal perforation or gas escape occurred.

Conclusions The combined technique was safe, effective and minimally invasive. No expensive materials were used. Lesion exposure, gastric content leakage, incomplete resection, and excessive normal tissue elimination were avoided. Human trials of this technique may be warranted.

 
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