A new stapler-based full-thickness transgastric access closure: results from an animal pilot trial

P Magno, SA Giday, X Dray, SS Chung, PB Cotton… - …, 2007 - thieme-connect.com
P Magno, SA Giday, X Dray, SS Chung, PB Cotton, CJ Gostout, RH Hawes, AN Kalloo…
Endoscopy, 2007•thieme-connect.com
Results: Peroral delivery and positioning of the stapling device involved some technical
difficulties, mostly due to the short length (60 cm) of the stapling device. The stapler provided
complete leak-resistant gastric closure in all pigs. None of the surviving animals had any
clinical signs of infection. Necropsy demonstrated an intact staple line with full-thickness
healing of the gastrotomy in all animals. Histologic examination confirmed healing, but also
revealed intramural micro-abscesses within the gastric wall after nonsterile procedure …
Results: Peroral delivery and positioning of the stapling device involved some technical difficulties, mostly due to the short length (60 cm) of the stapling device. The stapler provided complete leak-resistant gastric closure in all pigs. None of the surviving animals had any clinical signs of infection. Necropsy demonstrated an intact staple line with full-thickness healing of the gastrotomy in all animals. Histologic examination confirmed healing, but also revealed intramural micro-abscesses within the gastric wall after nonsterile procedure.
Conclusions: Gastrotomy closure with a perorally delivered flexible stapling device created a leak-resistant transmural line of staples followed by full-thickness healing of the gastric wall incision. Increasing the length of the instrument and adding device articulation will further facilitate its use for NOTES procedures.
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