Endoscopy 2007; 39(5): 466-470
DOI: 10.1055/s-2007-966392
Innovation forum

© Georg Thieme Verlag KG Stuttgart · New York

The ShapeLock system adapted to intragastric and transgastric surgery

P.  Swain1
  • 1Department of Surgical Oncology and Technology, Imperial College, London, UK,
Further Information

Publication History

Publication Date:
22 May 2007 (online)

Endoluminal and transgastric surgical procedures present challenges for current endoscopes and instruments which, especially when retroflexed, are too flexible and do not permit transmission of adequate force. The USGI TransPort is a multilumen surgical access system designed to enable endosurgical therapy. ShapeLock technology allows the TransPort to have either a flexible or a rigid state. In flexible mode, the TransPort is introduced and steered to a precise location. It is then locked by squeezing a handle, to provide a rigid platform for therapeutic procedures. A new device for tissue grasping and approximation, the g-Prox, has been designed for use with the TransPort, and this new endosurgical system has been tested in a series of intragastric and transgastric procedures in pigs and human cadavers. The experiments demonstrated the potential for using the TransPort platform to improve flexible endoluminal and transluminal procedures, including intragastric and transgastric fundoplication, cholecystectomy, gastric restriction, and gastric full-thickness incision closure.

References

  • 1 Swanstrom L L, Kozarek R, Pasricha P J. et al . Development of a new access device for transgastric surgery.  J Gastrointest Surg. 2005;  9 1129-1136; discussion 1136 - 1137
  • 2 Swain P, Kosarek R, Pasricha P J. et al . The development and testing of a new multichannel, Shape-Locking guide with tip and mid body articulation for intragastric endosurgery.  Gastrointest Endosc. 2005;  61 AB183
  • 3 Pasricha P, Kozarek R, Swain P. et al . A next generation therapeutic endoscope: development of a novel endoluminal surgery system with ”birds-eye” visualization and triangulating instruments.  Gastrointest Endosc. 2005;  61 AB106-0
  • 4 Raju G S, Pasricha P J. ShapeLock: a rapid access port for redeployment of a colonoscope into the proximal colon to facilitate multiple polypectomies in a single session.  Gastrointest Endosc. 2005;  61 768-770
  • 5 Rex D K, Khashab M, Raju G S. et al . Insertability and safety of a shape-locking device for colonoscopy.  Am J Gastroenterol. 2005;  100 817-820
  • 6 Sclabas G M, Swain P, Swanstrom L L. Endoluminal methods for gastrostomy closure in natural orifice transenteric surgery (NOTES).  Surg Innov. 2006;  13 23-30
  • 7 DePaula A L, Kozarek R A, Birkett D H. et al .A novel system for performing endoluminal antireflux suregery and other endosurgical procedures. Los Angeles; M2286, Digestive Disease Week (DDW) May 19 - 25, 2006
  • 8 Hill L. D, Kosarek R, Kraemer SJ et al. The gastroesophageal flap valve: in vitro and in vivo observations.  Gastrointest Endosc. 1996;  44 541-547
  • 9 Mellinger J D, Macfadyen B V, Kozarek R A. et al . Initial experience with a novel endoscopic device allowing intragastric manipulation and plication.  Gastrointest Endosc. 2006;  63 AB101
  • 10 Swain P, Ewers R, Peh R, Sadaat V. New measurement methods and a randomized comparison of force transmission using flexible endoscopes and instruments before and after the application of Shapelock™ technology.  Gastrointest Endosc. 2005;  61 AB241-AB250
  • 11 Swain P, Rothe C, Bergstrom M. et al . Development and testing of a new platform for retroflexed flexible transgastric surgery: cholecystectomy, fundoplication, gastric restriction and diaphragmatic repair.  Gastrointest Endosc. 2006;  63 AB102
  • 12 Pai R D, Carr-Locke D L, Thompson C C. Endoscopic evaluation of the defunctionalized stomach using Shapelock technology.  Gastrointest Endosc. 2006;  63 AB88
  • 13 Merrifield B F, Wagh M S, Thompson C C. Peroral transgastric organ resection: a feasibility study in pigs.  Gastrointest Endosc. 2006;  63 693-697
  • 14 Pai R D, Fong D G, Bundga M E. et al . Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model [with video].  Gastrointest Endosc. 2006;  64 428-434

C. P. Swain, MD 

Department of Surgical Oncology and Technology, Imperial College

41 Willow Road
London NW3 1TN
UK

Fax: +44-20-77942797

Email: PaulSwain1@compuserve.com

    >