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Laparoscopic modified Sugiura procedure: experimental study on the pig
E C Tsimoyiannis1, P Siakas, A Tassis
1Department of Surgery, G. Hatzikosta General Hospital, Ioannina, Greece.
International Surgery
|July 1, 1997
Summary
This study demonstrates the feasibility of a laparoscopic Sugiura procedure for gastroesophageal varices. The novel technique involves laparoscopic esophageal transection using an EEA stapler, offering a minimally invasive alternative.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Innovation
Background:
- The Sugiura procedure is an established treatment for bleeding gastroesophageal varices.
- Laparoscopic approaches to the Sugiura procedure have not been previously documented.
- This study addresses the need for minimally invasive surgical options for this condition.
Purpose of the Study:
- To develop a laparoscopic esophageal transection technique utilizing an EEA stapler.
- To establish a complete laparoscopic modified Sugiura procedure.
- To evaluate the feasibility of this novel laparoscopic approach.
Main Methods:
- The study involved six female farm pigs (40-50 kg) using six trocars.
- Key steps included laparoscopic esophageal mobilization, vagotomy, EEA stapler-assisted resection-anastomosis, devascularization, splenectomy, Nissen fundoplication, and pyloroplasty.
- Surgical outcomes were assessed, including operative time and blood loss, with post-procedure autopsy to evaluate staple line integrity.
Main Results:
- The mean operative time was 180 minutes.
- The mean blood loss was 260 ml.
- Autopsy confirmed the integrity of all staple lines at the conclusion of the procedure.
Conclusions:
- A complete laparoscopic modified Sugiura procedure, including laparoscopic esophageal transection with an EEA stapler, is feasible.
- This technique represents a potentially viable minimally invasive surgical option for managing gastroesophageal varices.
- Further research may explore clinical applications and long-term outcomes.