Experimental studies of Peroral Transgastric Abdominal Surgery

Abstract

Background: Recent studies are testing the feasibility of an
incisionless endoscopic per-oral approach to the peritoneal
cavity in experimental animals. Herein we present our results
of peroral peritoneoscopy, liver biopsy, cholecystectomy,
fallopian tube and uterus excision, in a porcine model to
determine the technical feasibility and safety of Peroral
Transgastric Procedures. Methods: The procedures were
performed on ten 28-50 Kgr anaesthetised pigs by using sterilized
double channel endoscope and catheters. The gastric
cavity was irrigated with antibiotic solution and access to
the peritoneal cavity was gained after stomach wall incision
with needle knife electrocautery. Peritoneoscopy (10 pigs),
liver biopsy (1 pig), cholecystectomy (6 pigs) fallopian tube
excision (one pig) and Hysterectomy (1 pig) were carried out.
Four acute and six survival experiments were performed.
Results: All procedures were accomplished successfully.
Easily handled complications occurred in two animals. The
feasibility of the peroral approach was demonstrated in all
acute experiments. In the survival experiments all pigs recovered
and thrived during the following four to six
weeks.Conclusion: Evidence is given that per-oral transgastric
surgery is technically feasible and safe in a porcine model.
The method has potential to become an alternative to laparoscopy.
Further evaluation in larger series is required.