Laparoscopic modified Sugiura procedure: experimental study on the pig
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E C Tsimoyiannis1, P Siakas, A Tassis
1Department of Surgery, G. Hatzikosta General Hospital, Ioannina, Greece.
Background:
The Sugiura procedure is an alternative treatment for bleeding gastroesophageal varices. Laparoscopic Sugiura procedure has not previously been described. The aim of this study is to develop a laparoscopic oesophageal transection with an EEA stapler, as well as a complete laparoscopic modified Sugiura procedure.
Methods:
We used six female farm pigs weighing 40-50 kg. Six trocars were used. The steps of the procedure are: 1) mobilization of the lower oesophagus and truncal vagotomy; 2) oesophageal resection-anastomosis with an EEA stapler; 3) devascularization of the corpus and fundus of the stomach and the lower 10 cm of the oesophagus; 4) splenectomy; 5) Nissen fundoplication; 6) pyloroplasty.
Results:
The mean operation time was 180 min, while the mean blood loss 260 ml. All staple lines are integral during autopsy at the end of the procedure.
Conclusions:
Laparoscopic oesophageal transection with an EEA stapler as well as a complete laparoscopic modified Sugiura procedure are feasible.