Long-term successful closure of a percutaneous intragastric trocar tract with crossing full-thickness sutures in a porcine model
submitted 19. Juli 2017
accepted after revision 16. Oktober 2017
08.Dezember 2017 (eFirst)
Background and study aims A novel intragastric trocar placed using a percutaneous endoscopic gastrostomy technique enables the use of laparoscopic tools and procedures, including tissue stapling, cutting, suturing, and retraction. The aim of this porcine study was to determine long-term success of crossing full-thickness sutures in closure of the tract upon trocar withdrawal.
Methods 10 trocars were placed in 5 animals. Each animal underwent a standardized tissue resection using a 5-mm stapler under gastroscopic guidance, and two full-thickness, absorbable, crossing sutures were used to close the trocar tracts. The animals were monitored for 35 days and then euthanized for necropsy.
Results All five animals survived without sign of infection or distress. Nine of the 10 trocar sites healed completely without any adverse findings. A single site developed a gastrocutaneous fistula. On necropsy, there was no evidence of intra-abdominal infection or abscess.
Conclusions Full-thickness crossing sutures appeared to be effective in long-term closure of an intragastric trocar tract. Given the ease of placement and success of this simple closure method, this device may prove clinically useful to the endoscopist performing complex procedures in the endoscopy suite.
- 1 Storm AC, Aihara H, Thompson CC. Novel intragastric trocar placed by PEG technique permits endolumenal use of rigid instruments to simplify complex endoscopic procedures. Gastrointest Endosc 2016; 84: 518-522
- 2 Storm AC, Aihara H, Skinner MJ. et al. A simply placed percutaneous intragastric trocar for use of laparoscopic tools in endoscopy. Gastrointest Endosc 2016; 84: 1051-1052
- 3 Soares RV, Molos M, Donepudi P. et al. Transgastric hybrid surgery for the flexible endoscopist: early experience with the TAGSS system. Gastrointest Endosc 2016; 84: 852-853
- 4 Schulman AR, Aihara H, Thompson CC. Treatment of gastrocutaneous fistula after percutaneous gastrostomy placement. Gastrointest Endosc 2016; 84: 851-852
- 5 World Medical Association, American Physiological Society. Guiding principles for research involving animals and human beings. Am J Physiol Regul Integr Comp Physiol 2002; 283: R281-283