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Intraluminal Endoscopic Suturing System in the Esophagus with Separate Instruments

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Innovative Endoscopic and Surgical Technology in the GI Tract

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Abstract

Early flexible endoscopic technology was lacking the deep bite to reach the muscularis of the gut wall. The plicator was quite successful in creating deep sutures to perform an antireflux plication of the gastric wall. Current versions of this technique are used for antireflux and gastric procedures. We have discussed the development of a rather simple mechanical technology, which enables the endoscopists in cooperation with surgeons to perform sutures in the esophagus and stomach, based on established minimal invasive technological principles and experience. We wanted to base our technique on commercially available flexible endoscopes, which would not require a major investment. The suturing system would be a needle holder, grasper, and knot pusher following the laparoscopic paradigm, again using basic mechanical technology with modified laparoscopic instruments. The Fortimedix Surgical™ flexible, articulating instruments are feasible to use and perform dependable intraluminal sutures. The training period is rather short, and the future perspective is to apply this system clinically for closure of perforations.

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Author information

Authors and Affiliations

  1. Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA

    Karl-Hermann Fuchs

  2. Department of Gastroenterology, Interventional and Experimental Endoscopy, University of Würzburg, Würzburg, Germany

    Karl-Hermann Fuchs

  3. University of California San Diego, Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA

    Kai Neki, Arielle M. Lee, Rebeca Dominguez & Brian Sandler

  4. Division of Minimally Invasive Surgery, Center for the Future of Surgery, Department of Surgery, La Jolla, CA, USA

    Brian Sandler

  5. University of California San Diego, Division of Minimally Invasive Surgery, La Jolla, CA, USA

    Santiago Horgan

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  1. Karl-Hermann Fuchs
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  2. Kai Neki
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  3. Arielle M. Lee
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  4. Rebeca Dominguez
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  5. Brian Sandler
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  6. Santiago Horgan
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Correspondence to Karl-Hermann Fuchs .

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Editors and Affiliations

  1. Division of Minimally Invasive Surgery, Center for Fluorescence-Guided Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Santiago Horgan

  2. Center for the Future of Surgery, University of California San Diego, La Jolla, CA, USA

    Karl-Hermann Fuchs

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Fuchs, KH., Neki, K., Lee, A.M., Dominguez, R., Sandler, B., Horgan, S. (2021). Intraluminal Endoscopic Suturing System in the Esophagus with Separate Instruments. In: Horgan, S., Fuchs, KH. (eds) Innovative Endoscopic and Surgical Technology in the GI Tract . Springer, Cham. https://doi.org/10.1007/978-3-030-78217-7_13

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