Feasibility of full-thickness gastric resection using master and slave transluminal endoscopic robot and closure by overstitch: A preclinical study
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摘要Background Gastric submucosal tumors are often treated by laparoscopic wedge resection. This study aimed to examine the feasibility of gastric full-thickness resection through a totally endoscopic approach using the master and slave transluminal endoscopic robot (MASTER), and closure of the luminal defect with an endoscopic suturing device. Methods The operation was performed in two live porcine models under general anesthesia. First, the anterior wall of the stomach was slung to the abdominal wall using a percutaneous suturing device. An imaginary 5-cm lesion was marked using a needle knife. After the initial mucosal incision was made using an IT knife, the MASTER was introduced through a long overtube. A circumferential mucosal incision was completed with the MASTER to expose the muscularis propria which was grasped and incised to the serosal layer by electrocautery applied through the hook of the MASTER. The full-thickness resection of the gastric wall was completed with retraction using the grasper and dissection using the hook. While the defect was being created, the luminal space was maintained with traction of the percutaneous sutures. The defect was closed with suture plication using an Apollo Overstitch device. Results Two full-thickness gastric resections were performed in two nonsurvival porcine models (body weight = 30 and 35 kg, respectively) using the MASTER. The total procedure time was 56 min for the first model and 70 min for the second model. The luminal view was maintained during the whole procedure, and there was no damage to surrounding organs throughout the whole procedure. The gastric defects were closed successfully using Overstitch, with satisfactory gastric distension and no gas leakage afterward. Conclusion The current experiment demonstrated the feasibility and safety of a totally endoscopic approach for the treatment of gastric submucosal tumors: full-thickness resection with the MASTER and successful closure of the defect using Overstitch. © Springer Science+Business Media New York 2013.
著者Chiu P.W.Y., Phee S.J., Wang Z., Sun Z., Poon C.C., Yamamoto T., Penny I., Wong J.Y.Y., Lau J.Y.W., Ho K.Y.
期刊名稱Surgical Endoscopy
出版年份2014
月份1
日期1
卷號28
期次1
出版社Springer Verlag
出版地Germany
頁次319 - 324
國際標準期刊號0930-2794
電子國際標準期刊號1432-2218
語言英式英語
關鍵詞Endoscopic full-thickness resection, MASTER endoscopic robot, Overstitch

上次更新時間 2020-22-10 於 02:25