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Transgastric endoscopic splenectomy: is it possible?

S V Kantsevoy¹, B Hu, S B Jagannath

¹Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, MD 21205, USA.

Surgical Endoscopy

|January 25, 2006

Summary

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Per-oral transgastric splenectomy using a flexible endoscope was technically feasible in a porcine model. This minimally invasive approach shows promise for future surgical applications.

Area of Science:

Minimally Invasive Surgery
Gastroenterology
Surgical Innovation

Background:

Previous studies established the feasibility of diagnostic and therapeutic peritoneoscopy via an oral transgastric route.
This research extends previous findings by investigating per-oral transgastric splenectomy.

Purpose of the Study:

To determine the technical feasibility of per-oral transgastric splenectomy.
To evaluate the use of a flexible endoscope for this procedure in a porcine model.

Main Methods:

Acute experiments were conducted on 50-kg pigs under general anesthesia.
A flexible endoscope was used to access the peritoneal cavity through a transgastric incision.
Splenic vessels were ligated using endoscopic loops and clips; mesentery was dissected with electrocautery.

Related Experiment Videos

Main Results:

Endoscopic splenectomy was successfully performed on six pigs without complications during gastric entry.
Excellent visualization of the spleen and other intraperitoneal organs was achieved.
Commercially available endoscopic devices were effective for vessel ligation and spleen mobilization.

Conclusions:

Transgastric endoscopic splenectomy is technically feasible in a porcine model.
Further long-term survival studies are planned to validate this approach.