Document Detail

Transoral obesity surgery: endoluminal gastroplasty with an endoscopic suture device.
MedLine Citation:
PMID:  15844017     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND STUDY AIMS: Surgical creation of a small gastric pouch with a restricted outlet is a well-established option for the treatment of morbid obesity. This report describes initial experience with endoscopic transoral stomach partition using a newly designed suturing apparatus. MATERIALS AND METHODS: A fresh porcine stomach was placed in the Erlangen model. A prototype suture device, incorporating a curved needle and an intracorporeal tightening mechanism, was used in this procedure. A long fishing line was first introduced into the stomach, with the two ends left outside. The suturing device, premounted outside a standard gastroscope, was inserted into the stomach and delivered several stitches attaching the fishing line to both the anterior and posterior walls along the line for the stomach to be partitioned. Five throws of half-hitches were tied onto the fishing line extracorporeally and separately pushed into place, creating a gastric pouch just below the esophagogastric junction. A flexible sheath of 8 cm long was then put on one side of the fishing line and pushed into the stomach. Additional extracorporeal knots were tied on the fishing line, forming a restrictive ring at the outlet of the pouch. The ring was then anchored to the stomach wall with similar endosutures. RESULTS: The proximal gastric pouch, with an estimated volume of approximately 100 ml, was successfully created with a restrictive band at its outlet. All of the stitches were securely sutured, with consistent penetration of the muscular layer of the stomach wall. CONCLUSIONS: In a bench model, it is technically possible to accomplish transoral gastroplasty endoscopically with an intraluminal suturing device. Further live animal studies will be needed in order to confirm the efficacy and safety of this procedure before clinical application.
B Hu; S C Chung; L C Sun; K Kawashima; T Yamamoto; P B Cotton; C J Gostout; R H Hawes; A N Kalloo; S V Kantsevoy; P J Pasricha
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Publication Detail:
Type:  In Vitro; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Endoscopy     Volume:  37     ISSN:  0013-726X     ISO Abbreviation:  Endoscopy     Publication Date:  2005 May 
Date Detail:
Created Date:  2005-04-21     Completed Date:  2005-08-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0215166     Medline TA:  Endoscopy     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  411-4     Citation Subset:  IM    
Endoscopy Center, Prince of Wales Hospital, Chinese University of Hong Kong, China.
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MeSH Terms
Equipment Design
Gastroplasty / instrumentation*,  methods
Obesity, Morbid / surgery*
Suture Techniques / instrumentation*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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