Abstract
Background
The aim of this study was to evaluate the feasibility of a totally stapled gastrojejunal anastomosis performed using one transabdominal 12-mm trocar and a gastroscope in a porcine model.
Methods
The procedure was carried out on six domestic pigs weighing 45 kg using a hybrid technique with a gastroscope and a 12-mm Hasson trocar, positioned in the left hypochondrium. At the end of the procedure a mechanical circular 21-mm gastrojejunal anastomosis was performed by inserting the stapler through a small gastrotomy after enlarging the trocar incision.
Results
In all six cases the procedure was completed through a single 3 cm abdominal incision and without complications. The mean operating time was 2 h, and endoscopic investigation showed that the anastomoses were intact, patent, and airtight.
Conclusions
Totally stapled gastrojejunal anastomosis using a hybrid NOTES—single 12-mm trocar approach is a feasible procedure in the porcine model. Further survival studies are warranted, particularly to evaluate the functional results of this procedure.
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Acknowledgments
The authors are grateful to Linda Inverso Moretti for editing the English version of the manuscript and to Silvio Ferron (Animal Surgical Experimental Centre) for his assistance with the technical aspects of these experiments.
Disclosure
Lino Polese, Stefano Merigliano, Benedetto Mungo, Roberto Rizzato, Roberto Luisetto, Ermanno Ancona, and Lorenzo Norberto have no conflicts of interest or financial ties to disclose.
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Polese, L., Merigliano, S., Mungo, B. et al. Totally stapled gastrojejunal anastomosis using hybrid NOTES: single 12-mm trocar approach in a porcine model. Surg Endosc 26, 2527–2531 (2012). https://doi.org/10.1007/s00464-012-2226-3
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DOI: https://doi.org/10.1007/s00464-012-2226-3