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

24 Citations (Scopus)

Abstract

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
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Volume23
Issue number6
DOIs
Publication statusPublished - 2013 Dec

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Stomach
Swine
Neoplasms
Abscess
Communication
Safety
Injections

Keywords

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

ASJC Scopus subject areas

  • Surgery

Cite this

Novel technique for full-thickness resection of gastric malignancy : Feasibility of nonexposed endoscopic wall-inversion surgery (NEWS) in porcine models. / Mitsui, Takashi; Goto, Osamu; Shimizu, Nobuyuki; Hatao, Fumihiko; Wada, Ikuo; Niimi, Keiko; Asada-Hirayama, Itsuko; Fujishiro, Mitsuihiro; Koike, Kazuhiko; Seto, Yasuyuki.

In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques, Vol. 23, No. 6, 12.2013.

Research output: Contribution to journalArticle

Mitsui, Takashi ; Goto, Osamu ; Shimizu, Nobuyuki ; Hatao, Fumihiko ; Wada, Ikuo ; Niimi, Keiko ; Asada-Hirayama, Itsuko ; Fujishiro, Mitsuihiro ; Koike, Kazuhiko ; Seto, Yasuyuki. / Novel technique for full-thickness resection of gastric malignancy : Feasibility of nonexposed endoscopic wall-inversion surgery (NEWS) in porcine models. In: Surgical Laparoscopy, Endoscopy and Percutaneous Techniques. 2013 ; Vol. 23, No. 6.
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