Endoscopic procedures advance physician knowledge and pa...( eaknesses and potential solutions. ...),Health

In this study, researchers from Gothenberg and London tested new technology applicable to NOTES as well as intraluminal endosurgery specifically, a new flexible endoscopic suturing method for intraluminal and transgastric surgery. Researchers evaluated the technique in porcine models and then reported the first clinical results in three patients. While many devices have been constructed to perform endoscopic suturing, most are complicated, expensive and difficult to use. Researchers evaluated the new method and found that it was not only easy to employ, but allowed for successful closure of perforations and approximate tissue without laparoscopic or open surgery.

The method involves passing flexible needles constrained within a plastic catheter loaded with metal tags down the working channel of a conventional endoscope. Two tags are placed into the wall of the stomach, one on each side of the defect. The threads are then locked together and cut. Precise stitch positioning is performed in the middle of the visual field and multiple stitches can be placed quickly without the need to remove the endoscope during the procedure.

Using this technique, researchers were able to close a perforated duodenal ulcer (ulcer in the small intestine) and leaking anastomosis (surgical connection of separate or severed parts of a tubular organ, such as the intestine) and stop upper gastrointestinal bleeding in patients when other methods had failed. They were also able to close perforations and perform gastro-jejunostomies (surgical formation of a passage between the stomach and small intestine) and pyloroplasty (surgery to open up narrowing of the junction between the stomach and duodenum) in porcine models.

"This method makes endoscopic suturing possible almost anywhere in the GI tract that can be reached by a flexible endoscope," said C. Paul Swain, M.D., of Royal London Hospital in London, UK
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Contact: Aimee Frank
AFrank@gastro.org
301-941-2620
American Gastroenterological Association
22-May-2007