Brief Article
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World J Gastroenterol. Apr 7, 2011; 17(13): 1732-1738
Published online Apr 7, 2011. doi: 10.3748/wjg.v17.i13.1732
Gastrotomy closure with a new tissue anchoring device: A porcine survival study
Carlos Guarner-Argente, Henry Córdova, Graciela Martínez-Pallí, Ricard Navarro-Ripoll, Antonio Rodríguez-d’Jesús, Cristina Rodríguez de Miguel, Mireia Beltrán, Gloria Fernández-Esparrach
Carlos Guarner-Argente, Henry Córdova, Antonio Rodríguez-d’Jesús, Cristina Rodríguez de Miguel, Mireia Beltrán, Gloria Fernández-Esparrach, Endoscopy Unit, Hospital Clínic, CIBERehd, Barcelona 08026, Spain
Graciela Martínez-Pallí, Ricard Navarro-Ripoll, Anesthesiology Department, Hospital Clínic, CIBERehd, Barcelona 08026, Spain
Author contributions: Fernández-Esparrach G designed the research; Fernández-Esparrach G, Guarner-Argente C, Córdova H, Martínez-Pallí G, Navarro-Ripoll R, Rodríguez-d’Jesús A, Rodríguez de Miguel C, Beltrán M performed the research, critically reviewed the article and approved the final version; Fernández-Esparrach G, Guarner-Argente C analyzed the data, drafted and wrote the paper.
Supported by A Grant from the Instituto de Salud Carlos III (PI08/90026)
Correspondence to: Gloria Fernández-Esparrach, MD, PhD, Endoscopy Unit, Gastroenterology Department, Hospital Clinic, Villarroel 170, Barcelona 08026,Spain. mgfernan@clinic.ub.es
Telephone: +34-93-2275513 Fax: +34-93-2275418
Received: November 9, 2010
Revised: December 1, 2010
Accepted: December 8, 2010
Published online: April 7, 2011
Abstract

AIM: To evaluate the feasibility, reproducibility and efficacy of a new tissue anchoring device in a porcine survival model.

METHODS: Gastrotomies were performed using a needle-knife and balloon dilator in 10 female Yorkshire pigs weighing 30-35 kg. Gastric closure was attempted using a new tissue anchoring device. The tightness of the closure was confirmed by means of air insufflation and the ability to maintain gastric distension with stability in peritoneal pressure measured with a Veress needle. All animals were monitored daily for signs of peritonitis and sepsis over 14 d. During necropsy, the peritoneal cavity and the gastric access site were examined.

RESULTS: Transgastric access, closure and 14 d survival was achieved in all pigs. The mean closure time was 18.1 ± 19.2 min and a mean of 2.1 ± 1 devices were used. Supplementary clips were necessary in 2 cases. The closure time was progressively reduced (24.8 ± 13.9 min in the first 5 pigs vs 11.4 ± 5.9 min in the last 5, P = NS). At necropsy, the gastric access site was correctly closed in all cases with all brace-bars present. One device was misplaced in the mesocolon. Minimal adhesions were observed in 3 pigs and signs of mild peritonitis and adhesions in one.

CONCLUSIONS: The use of this new tissue anchoring device in porcine stomachs is feasible, reproducible and effective and requires a short learning curve.

Keywords: Gastrotomy, Closure, Suture, Survival, Porcine model, Notes