Full-thickness laparoendoscopic excision in the stomach: the FLEx technique
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Published on: December 27, 2024
Robin H Kennedy1, Ronan A Cahill, Adela Brigic
1Department of Surgery, St Mark's Hospital, Harrow, UK. Robin.Kennedy@nwlh.nhs.uk
Background:
The authors describe the initial validation of a novel full-thickness laparoendoscopic excision (FLEx) technique for the stomach.
Methods:
The technique was studied in seven 50-kg pigs. Secure full-thickness excision was ensured by inversion excision target with a 1-cm circumferential margin using laparoendoscopically placed brace bars passed intraluminally from the outside of the stomach, laparoscopic oversewing of the site of inversion, and endoscopic full-thickness excision using a dual scope approach. Pigs were sacrificed either immediately (n = 3) or between 7 and 10 days after surgery (n = 4).
Results:
The procedure achieved uncomplicated full-thickness excision in every case. Median procedure duration was 227 minutes (range = 210-245 minutes). Median specimen diameter was 5.5 cm (range = 2.5-8 cm). Investigative autopsy confirmed technical sufficiency in all animals. Median site bursting pressure was 130 mm Hg (range = 120-160 mm Hg).
Conclusions:
The FLEx technique proved useful for excision of small localized lesions of the stomach in this animal study.
