Tissue anchors for transmural gut-wall apposition.
Diahann L Seaman1, Christopher J Gostout, Jose G de la Mora Levy
1Developmental Endoscopy Unit, Mayo Clinic, Rochester, Minnesota 55905, USA.
Gastrointestinal Endoscopy
|September 26, 2006
Summary
New endoscopic tissue anchors show promise for gastric surgery. Basket anchors were most effective, creating durable tissue apposition for potential natural orifice transluminal endoscopic surgery (NOTES) applications.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Biomedical Engineering
Background:
- Advanced endoscopic procedures like natural orifice transluminal endoscopic surgery (NOTES) require robust tissue closure methods.
- Current suturing and clipping devices have limitations for complex gastric procedures.
- Novel endoscopic tissue apposition techniques are needed for gastric reduction surgery.
Purpose of the Study:
- To evaluate prototype endoscopic tissue anchors for transmural tissue apposition.
- To identify functional tissue anchors deployable via flexible endoscopic devices.
- To assess the efficacy of different anchor designs in gastric tissue.
Main Methods:
- A short-term animal survival study was conducted using domestic pigs.
- Four prototype tissue anchor designs (T bar, T bar with mesh, star, basket) were tested.
- Gastric plications were created and secured with anchors, with some animals undergoing a pilot gastric reduction.
Main Results:
- Anchor retention varied, with basket anchors showing the highest retention rate (78%).
- Basket anchors facilitated the tallest plications with apposed muscularis propria and serosal fusion.
- No gastric adhesions or inflammatory changes were observed around the stomachs.
Conclusions:
- The basket tissue anchor design demonstrated the most promising results in this study.
- Further development of catheter-based tissue anchors could offer clinical value for transmural gastric tissue apposition.
- Endoscopic tissue anchors represent a potential advancement for NOTES and gastric surgery.
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