Cerca
image du produit
Gastrointestinal Endoscopy

Abbonarsi

Air and fluid leak tests after NOTES procedures: a pilot study in a live porcine model (with videos) - 23/08/11

Doi : 10.1016/j.gie.2007.12.052 
Xavier Dray, MD, Kathleen L. Gabrielson, DVM, PhD, Jonathan M. Buscaglia, MD, Eun Ji Shin, MD, Samuel A. Giday, MD, Vihar C. Surti, BS, Lia Assumpcao, MD, Michael R. Marohn, DO, Priscilla Magno, MD, Laurie J. Pipitone, BS, Susan K. Redding, BVSc, Anthony N. Kalloo, MD, Sergey V. Kantsevoy, MD, PhD ⁎
Current affiliations: Division of Gastroenterology (X.D., J.M.B., E.J.S., S.A.G., P.M., A.N.K., S.V.K.), Department of Molecular and Comparative Pathobiology (K.L.G.), Department of Surgery (L.A., M.R.M.), and Department of Radiology (L.J.P., S.K.R.), Johns Hopkins School of Medicine, Baltimore, Maryland, USA, Department of Digestive Diseases (X.D.), Hôpital Lariboisière, Paris, France, Cook Endoscopy Inc (V.C.S.), Winston-Salem, North Carolina, USA, Department of Medicine (P.M.), University of Puerto Rico, San Juan, Puerto Rico 

Reprint requests: Sergey V. Kantsevoy, MD, PhD, Division of Gastroenterology, Johns Hopkins University School of Medicine, 1830 E Monument St, Room 423, Baltimore, MD 21205.

Baltimore, Maryland, Winston-Salem, North Carolina, USA, Paris, France, San Juan, Puerto Rico

Abstract

Background

Transluminal access site closure remains a major challenge in natural orifice transluminal endoscopic surgery (NOTES).

Objective

Our purpose was to develop in vivo leak tests for evaluation of the integrity of transgastric access closure.

Settings

Survival experiments on 12 50-kg pigs.

Design and Interventions

After a standardized transgastric approach to the peritoneal cavity and peritoneoscopy, the gastric wall incision was closed with T-bars (Wilson-Cook Medical, Winston-Salem, NC) deployed on both sides of the incision and then cinched together. Gastrotomy closure was assessed with air and fluid leak tests. The animals were observed for 1 week and then underwent endoscopic evaluation and necropsy.

Main Outcome Measurements

(1) Leak-proof closure of the gastric wall incision. (2) Gastric incision healing 1 week after the procedure.

Results

The mean intraperitoneal pressure increased 10.7 ± 3.7 mm Hg during gastric insufflation when the air leak test was performed before closure compared with 0.9 ± 0.8 mm Hg after transmural closure of the transgastric access site with T-bars (P < .001). Fluid leak tests demonstrated no leakage of liquid contrast from the stomach into the peritoneal cavity after closure. Necropsy in 1 week confirmed completeness of the gastric closure in all animals with full-thickness healing and no spillage of the gastric contents into the peritoneal cavity.

Limitations

Leak tests were only evaluated on an animal model.

Conclusions

Fluid and air leak tests are simple techniques to evaluate in vivo the adequacy of the transluminal access site closure after NOTES procedures. Leak-proof gastric closure resulted in adequate tissue approximation and full-thickness healing of the gastric wall incision.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : IRB, NOTES


Mappa


© 2008  American Society for Gastrointestinal Endoscopy. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
Aggiungere alla mia biblioteca Togliere dalla mia biblioteca Stampare
Esportazione

    Citazioni Export

  • File

    •

  • Contenuto

    •

Vol 68 - N° 3

P. 513-519 - settembre 2008 Ritorno al numero
Articolo precedente Articolo precedente
  • On computers, nurses, and propofol: further evidence for the jury?
  • Mohamad Iravani
| Articolo seguente Articolo seguente
  • Biochromoendoscopy: molecular imaging with capsule endoscopy for detection of adenomas of the GI tract
  • Howard Zhang, Douglas Morgan, Gerald Cecil, Adam Burkholder, Nicole Ramocki, Brooks Scull, P. Kay Lund

Benvenuto su EM|consulte, il riferimento dei professionisti della salute.
L'accesso al testo integrale di questo articolo richiede un abbonamento.

Già abbonato a @@106933@@ rivista ?

@@150455@@ Voir plus

Il mio account

Aide & support

Dichiarazione CNIL

EM-CONSULTE.COM è registrato presso la CNIL, dichiarazione n. 1286925.

Ai sensi della legge n. 78-17 del 6 gennaio 1978 sull'informatica, sui file e sulle libertà, Lei puo' esercitare i diritti di opposizione (art.26 della legge), di accesso (art.34 a 38 Legge), e di rettifica (art.36 della legge) per i dati che La riguardano. Lei puo' cosi chiedere che siano rettificati, compeltati, chiariti, aggiornati o cancellati i suoi dati personali inesati, incompleti, equivoci, obsoleti o la cui raccolta o di uso o di conservazione sono vietati.
Le informazioni relative ai visitatori del nostro sito, compresa la loro identità, sono confidenziali.
Il responsabile del sito si impegna sull'onore a rispettare le condizioni legali di confidenzialità applicabili in Francia e a non divulgare tali informazioni a terzi.

Tutto il contenuto di questo sito: Copyright © 2026 Elsevier, i suoi licenziatari e contributori. Tutti i diritti sono riservati. Inclusi diritti per estrazione di testo e di dati, addestramento dell’intelligenza artificiale, e tecnologie simili. Per tutto il contenuto ‘open access’ sono applicati i termini della licenza Creative Commons.