Development of a new access device for transgastric surgery

Area of Science:

• Medical Devices
• Surgical Technology
• Gastrointestinal Endoscopy

Background:

• Current flexible endoscopes lack the rigidity and instrumentation for complex endoluminal and transgastric surgeries.
• Challenges include inadequate grasping, retraction, and multi-instrument manipulation, limiting surgical capabilities.

Purpose of the Study:

• To develop and evaluate a novel articulating flexible endoscopic system for endoluminal and transgastric surgery.
• To address limitations of existing endoscopes for complex abdominal procedures.

Main Methods:

• A multidisciplinary team designed and prototyped a new flexible endoscopic system with multilumen channels and angulation capabilities.
• Prototypes were tested on inanimate models, followed by in-vivo testing in pigs and dogs for various surgical tasks.

Main Results:

• The new system, featuring multilumen guides and angulation, successfully facilitated transgastric procedures in animal models.
• High success rates were achieved for liver biopsy (90%) and cecal retraction (100%), with variable success for cholecystectomy (33.3%) and hiatal exposure (50%).

Conclusions:

• The developed endosurgical multilumen device and instrumentation provide a viable platform for advanced transgastric procedures.
• This technology shows potential for future applications in minimally invasive surgeries like cholecystectomy and hernia repair.