TY - JOUR
T1 - Novel technique for full-thickness resection of gastric malignancy
T2 - Feasibility of nonexposed endoscopic wall-inversion surgery (NEWS) in porcine models
AU - Mitsui, Takashi
AU - Goto, Osamu
AU - Shimizu, Nobuyuki
AU - Hatao, Fumihiko
AU - Wada, Ikuo
AU - Niimi, Keiko
AU - Asada-Hirayama, Itsuko
AU - Fujishiro, Mitsuihiro
AU - Koike, Kazuhiko
AU - Seto, Yasuyuki
PY - 2013/12
Y1 - 2013/12
N2 - 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.
AB - 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.
KW - early gastric cancer
KW - full-thickness resection
KW - gastric submucosal tumor
KW - laparoscopic and endoscopic cooperative surgery
KW - minimally invasive
KW - nonexposure
UR - http://www.scopus.com/inward/record.url?scp=84890624585&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84890624585&partnerID=8YFLogxK
U2 - 10.1097/SLE.0b013e31828e3f94
DO - 10.1097/SLE.0b013e31828e3f94
M3 - Article
C2 - 24300935
AN - SCOPUS:84890624585
VL - 23
SP - e217-e221
JO - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
JF - Surgical Laparoscopy, Endoscopy and Percutaneous Techniques
SN - 1530-4515
IS - 6
ER -
