Background and aim: Current endoscopic full-thickness resection (EFTR) methods are limited by their transmural
communication and exposure of tumor to the peritoneum. The aim of this study was to
test the feasibility of a new resection technique that does not expose the mucosa
to the peritoneum, although it involves an easy and secure suture method, which could
be applied in the clinical setting.
Methods: The nonexposure endolaparoscopic full-thickness resection with simple suturing technique
was performed in four pigs. This new technique includes the steps of laparoscopic
seromuscular suturing, which results in inversion of the stomach wall; EFTR of the
inverted stomach wall from inside the stomach; and finally, endoscopic mucosal suturing
with endoloops and clips.
Results: En bloc and complete resections were achieved without adverse events in all pigs.
The mean (± standard deviation) operation time was 137.0 ± 28.2 minutes. All pigs
survived with no clinical evidence of illness until euthanasia. Gross and microscopic
examination of the resection site showed healing without evidence of leakage or infection.
Conclusion: The nonexposure endolaparoscopic full-thickness resection with simple suturing technique
was feasible in an animal model.
