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Updated: Aug 17, 2026
Single-port Robotic Transanal Total Mesorectal Excision in a Porcine Model (Sus scrofa domesticus)
Published on: April 3, 2026
Endoscopic full-thickness resection with sutured closure in a porcine model
Keiichi Ikeda1, Annette Fritscher-Ravens, C Alexander Mosse
1Department of Endoscopy, The Jikei University School of Medicine, Tokyo, Japan.
Background:
Some early gastric cancers might be advantageously staged and treated by full-thickness resection if secure methods for closing the defect were available. The aim of this study was to test the feasibility of full-thickness gastric resection.
Methods:
Full-thickness gastric resections were performed by using a ligating device without submucosal injection in survival studies in pigs (n = 8). The defects were closed by using new methods for suturing, locking, and cutting thread through a 2.8-mm accessory channel. Stitches (n = 2-4) were placed close to the target area before resection.
Observations:
Full-thickness resections (n = 8) were performed. The pigs survived without incident for 21 to 28 days. Healing of the suture site was evident at follow-up endoscopy. Suture sites were water tight. The pull-out force with stitches by using this new sewing method was significantly higher than with endoscopic clips (20.3 N +/- 0.94 vs. 2.2 N +/- 0.42, p < 0.05).
Conclusions:
Endoscopic full-thickness resection with sutured defect closure was feasible and appeared safe in these survival experiments.
