Novel technique for full-thickness resection of gastric malignancy: Feasibility of nonexposed endoscopic wall-inversion surgery (NEWS) in porcine models

Takashi Mitsui, Osamu Goto, Nobuyuki Shimizu, Fumihiko Hatao, Ikuo Wada, Keiko Niimi, Itsuko Asada-Hirayama, Mitsuihiro Fujishiro, Kazuhiko Koike, Yasuyuki Seto

Research output: Contribution to journalArticle

27 Citations (Scopus)


Full-thickness resection for gastric malignancy carries a risk of peritoneal dissemination due to opening of the gastric lumen. We evaluated the feasibility and safety a novel method of full-thickness resection without transmural communication, called nonexposed endoscopic wall-inversion surgery in ex vivo and in vivo porcine models. Six explanted porcine stomachs and 6 live pigs were used for this study. After marking and submucosal injection around 3 cm simulated lesions, the seromuscular layer was laparoscopically cut and sutured with the lesion inverted to the inside. Consecutively, a mucosubmucosal incision was made endoscopically. Three pigs used for the survival study were monitored for 7 days. All 12 lesions were successfully resected en bloc without perforation. The 3 pigs survived for 1 week without adverse events, and necropsy revealed neither leakage nor abscess formation related to the operation. We demonstrated nonexposed endoscopic wall-inversion surgery to be technically feasible and safe in both ex vivo and in vivo porcine studies.

Original languageEnglish
Pages (from-to)e217-e221
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Issue number6
Publication statusPublished - 2013 Dec 1



  • early gastric cancer
  • full-thickness resection
  • gastric submucosal tumor
  • laparoscopic and endoscopic cooperative surgery
  • minimally invasive
  • nonexposure

ASJC Scopus subject areas

  • Surgery

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