Endoscopic pyloroplasty with full-thickness transgastric and transduodenal myotomy with sutured closure.
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Endoscopic pyloroplasty with full-thickness transgastric and transduodenal myotomy with sutured closure. / Park, Per-Ola; Bergström, Maria; Ikeda, Keiichi; Fritscher Ravens, Annette; Mosse, Sandy; Kochman, Michael; Swain, Paul.
In: GASTROINTEST ENDOSC, Vol. 66, No. 1, 1, 2007, p. 116-120.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Endoscopic pyloroplasty with full-thickness transgastric and transduodenal myotomy with sutured closure.
AU - Park, Per-Ola
AU - Bergström, Maria
AU - Ikeda, Keiichi
AU - Fritscher Ravens, Annette
AU - Mosse, Sandy
AU - Kochman, Michael
AU - Swain, Paul
PY - 2007
Y1 - 2007
N2 - BACKGROUND: Pyloroplasty with myotomy and sutured closure is a surgical treatment for gastric outlet obstruction. It has not been previously performed at flexible endoscopy. OBJECTIVE: To develop and test a method for performing a sutured pyloroplasty at flexible endoscopy. DESIGN: A Heinicke-Miculicz pyloroplasty was performed, forming a linear myotomy through the pylorus from the gastric side into the duodenal bulb. This was subsequently sutured transversely to increase the opening. The operation was performed in 3 nonsurvival studies in pigs. The safety and the efficacy was then studied in 7 animals followed for up to 4 weeks after the procedure. SETTING: The studies were performed in experimental surgical units in Gothenburg, Sweden, and London, UK. INTERVENTIONS: A linear needle-knife incision was made through the pylorus; full-thickness sutures, by using a new T-tag and polypropylene thread suturing system through a flexible gastroscope, were placed to close the incision transversely. In 2 pigs, the prepyloric bulge was excised before the pyloroplasty. RESULTS: Pyloroplasty was readily accomplished at flexible endoscopy in the 3 nonsurvival studies. Six of 7 pigs that survived in this study for periods of 7 to 28 days, recovered well, without complications. One pig (with bulge removal) developed gastric retention. The pyloric opening was increased; it was then easy to enter the duodenum at follow-up endoscopy. LIMITATIONS: This method has yet to be studied clinically. CONCLUSIONS: Pyloroplasty with full-thickness pyloromyotomy and transverse closure of a linear myotomy was accomplished by using a simple flexible endosurgical technique to test a new flexible suturing system.
AB - BACKGROUND: Pyloroplasty with myotomy and sutured closure is a surgical treatment for gastric outlet obstruction. It has not been previously performed at flexible endoscopy. OBJECTIVE: To develop and test a method for performing a sutured pyloroplasty at flexible endoscopy. DESIGN: A Heinicke-Miculicz pyloroplasty was performed, forming a linear myotomy through the pylorus from the gastric side into the duodenal bulb. This was subsequently sutured transversely to increase the opening. The operation was performed in 3 nonsurvival studies in pigs. The safety and the efficacy was then studied in 7 animals followed for up to 4 weeks after the procedure. SETTING: The studies were performed in experimental surgical units in Gothenburg, Sweden, and London, UK. INTERVENTIONS: A linear needle-knife incision was made through the pylorus; full-thickness sutures, by using a new T-tag and polypropylene thread suturing system through a flexible gastroscope, were placed to close the incision transversely. In 2 pigs, the prepyloric bulge was excised before the pyloroplasty. RESULTS: Pyloroplasty was readily accomplished at flexible endoscopy in the 3 nonsurvival studies. Six of 7 pigs that survived in this study for periods of 7 to 28 days, recovered well, without complications. One pig (with bulge removal) developed gastric retention. The pyloric opening was increased; it was then easy to enter the duodenum at follow-up endoscopy. LIMITATIONS: This method has yet to be studied clinically. CONCLUSIONS: Pyloroplasty with full-thickness pyloromyotomy and transverse closure of a linear myotomy was accomplished by using a simple flexible endosurgical technique to test a new flexible suturing system.
M3 - SCORING: Zeitschriftenaufsatz
VL - 66
SP - 116
EP - 120
JO - GASTROINTEST ENDOSC
JF - GASTROINTEST ENDOSC
SN - 0016-5107
IS - 1
M1 - 1
ER -