Transgastric endoscopic splenectomy
Transgastric endoscopic splenectomy
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经胃内镜脾切除术
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
A. Kalloo
中科院分区：
文献类型：
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作者：
S. Kantsevoy;B. Hu;S. Jagannath;C. A. Vaughn;D. Beitler;S. C. Chung;Peter B. Cotton;C. Gostout;Robert H. Hawes;P. J. Pasricha;C. Magee;L. J. Pipitone;M. Talamini;A. Kalloo
背景我们以前报道过腹腔镜诊断和治疗的可行性，包括肝活检、胃空肠吻合术和经口经胃输卵管结扎术。我们目前的结果，经口经胃脾切除术在猪模型。本研究的目的是确定经口transgastric脾切除术的技术可行性，使用一个灵活的endoscope.MethodsWe进行急性实验50公斤猪。所有动物在手术前3天喂食液体。手术在气管插管全身麻醉下进行。经口将软式内窥镜插入胃内，用针刀穿刺胃壁。使用牵引式括约肌切开器延长穿刺以创建1.5 cm切口，并将双通道内窥镜推进到腹膜腔中。通过内窥镜向腹膜腔吹入空气。观察脾脏。脾血管结扎内镜环和剪辑，然后肠系膜解剖使用electrocautery.ResultsEndoscopic脾切除术进行了6只猪。胃切开及腹腔入路均无并发症。脾脏和其他腹腔内器官的可视化非常好。结扎的脾血管和动员的脾脏使用市售的设备和内窥镜accessors.ConclusionsTransgastric内镜脾切除术在猪模型技术上是可行的。计划进行更多的长期生存实验。
BackgroundWe have previously reported the feasibility of diagnostic and therapeutic peritoneoscopy including liver biopsy, gastrojejunostomy, and tubal ligation by an oral transgastric approach. We present results of per-oral transgastric splenectomy in a porcine model. The goal of this study was to determine the technical feasibility of per-oral transgastric splenectomy using a flexible endoscope.MethodsWe performed acute experiments on 50-kg pigs. All animals were fed liquids for 3 days prior to procedure. The procedures were performed under general anesthesia with endotracheal intubation. The flexible endoscope was passed per orally into the stomach and puncture of the gastric wall was performed with a needle knife. The puncture was extended to create a 1.5-cm incision using a pull-type sphincterotome, and a double-channel endoscope was advanced into the peritoneal cavity. The peritoneal cavity was insufflated with air through the endoscope. The spleen was visualized. The splenic vessels were ligated with endoscopic loops and clips, and then mesentery was dissected using electrocautery.ResultsEndoscopic splenectomy was performed on six pigs. There were no complications during gastric incision and entrance into the peritoneal cavity. Visualization of the spleen and other intraperitoneal organs was very good. Ligation of the splenic vessels and mobilization of the spleen were achieved using commercially available devices and endoscopic accessories.ConclusionsTransgastric endoscopic splenectomy in a porcine model appears technically feasible. Additional long-term survival experiments are planned.