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Endoscopic full-thickness closure of large gastric perforations by use of tissue anchors
Kazuki Sumiyama1, Christopher J Gostout, Elizabeth Rajan
1Developmental Endoscopy Unit, Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Background:
A flexible needle-catheter tissue-anchoring device was developed to accomplish full-thickness tissue apposition of the GI wall. The aim of this study was to identify the performance of this device for repair of large iatrogenic gastric perforations in a porcine model.
Objectives:
Six pigs.
Design:
Short-term survival animal study.
Settings:
Pigs were studied while they were under general anesthesia. Device performance in differing gastric locations and wall thicknesses was assessed by 2 perforations more than 2 cm in size created for each pig along the greater curvature and the anterior wall.
Interventions:
Each perforation was closed by parallel placement of tissue anchor sets sequentially along the length of the perforation.
Main Outcome Measurements:
One week follow-up endoscopy and necropsy were performed.
Results:
Twelve perforations were closed with the 48 tissue anchor sets. All animals survived for 1 week without clinical complications. Follow-up endoscopy and necropsy revealed that all tissue anchors remained with firmly held sutures and sealed perforations.
Conclusions:
Full-thickness closure with a new tissue-anchoring device simply and successfully repaired large iatrogenic gastric perforations.
