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Transluminal endosurgery: single lumen access anastomotic device for flexible endoscopy
Annette Fritscher-Ravens1, C Alexander Mosse, Dipankar Mukherjee
1Academic Department of Gastroenterology, The Royal London Hospital, Whitechapel, United Kingdom.
Gastrointestinal Endoscopy
|October 2, 2003
Summary
This study presents a novel endoscopic technique for creating gastrointestinal anastomoses using a modified needle and catheter system. This method enables the formation of connections between hollow organs with access to only one lumen, potentially reducing surgical interventions.
Area of Science:
- Gastroenterology
- Surgical Innovation
- Medical Device Development
Background:
- Endoscopic anastomosis formation can minimize surgery for malignant obstructions.
- Current techniques necessitate access to both lumens of hollow organs.
- A new method is needed for single-lumen access anastomosis.
Purpose of the Study:
- To develop and evaluate a novel endoscopic technique for creating gastrointestinal anastomoses.
- To enable anastomosis formation when only one lumen is accessible.
- To potentially reduce the need for surgical intervention in cases of obstructing malignancy.
Main Methods:
- A modified needle passed through an echoendoscope from the accessible lumen into the target organ.
- Anastomotic device created using two 7F catheter segments deployed over a guidewire.
- Catheters formed a cross shape upon guidewire withdrawal, creating an anastomosis when compressed.
Main Results:
- The technique was successfully tested in live animal models (pigs).
- Anastomoses were formed between the stomach and small intestine, and stomach and gallbladder.
- Successful anastomosis formation occurred within 4 to 7 days with no reported complications.
Conclusions:
- Anastomosis formation is feasible using flexible endoscopy with single-lumen access.
- This technique offers a potential alternative to surgery for certain conditions.
- Further research may validate this approach for clinical application.