Experimenting percutaneous endoscopic intragastric surgery (PEIGS): challenges and opportunities

Area of Science:

• Minimally invasive surgery
• Gastroenterology
• Surgical instrumentation

Background:

• Percutaneous endoscopic intragastric surgery (PEIGS) is an emerging minimally invasive technique.
• Widespread adoption requires improved, user-friendly equipment and refined surgical techniques.
• Demonstration of feasibility, safety, and efficacy is crucial for clinical advancement.

Purpose of the Study:

• To present improvements in gastric access cannula design for PEIGS.
• To demonstrate the feasibility and efficacy of PEIGS through animal experiments.

Main Methods:

• Conducted nine experiments on fresh sheep stomachs.
• Performed one living nonsurviving animal experiment.
• Analyzed spatial orientation factors and endoscope/instrument positioning within the stomach model.

Main Results:

• Demonstrated the feasibility and efficacy of PEIGS in an animal model.
• Identified critical factors for spatial orientation during intragastric procedures.
• Optimized endoscope and instrument positioning for accessing various gastric regions.

Conclusions:

• PEIGS is a promising approach for complex intragastric surgical interventions.
• Further advancements in equipment and extensive animal and clinical studies are necessary.
• Addressing current challenges will facilitate the broader application of PEIGS.