Immediate endoscopic closure of colon perforation by using a prototype endoscopic suturing device: feasibility and outcome in a porcine model (with video){A figure is presented}

Binh V. Pham, Gottumukkala S. Raju, Ijaz Ahmed, Douglas Brining, Sydney Chung, Peter Cotton, Christopher J. Gostout, Robert H. Hawes, Anthony N. Kalloo, Sergey V. Kantsevoy, Pankaj Jay Pasricha

Research output: Contribution to journalArticlepeer-review

84 Scopus citations

Abstract

Background: Perforation is an uncommon but potentially devastating complication of colonoscopy. Surgical closure is the standard of care. Immediate endoluminal closure of a perforation would avoid the morbidity and mortality associated with general anesthesia, laparotomy, and surgical repair. Objectives: To evaluate the feasibility and safety of full-thickness endoscopic closure of colonic perforations with a prototype endoscopic suturing device, the Eagle Claw, in a porcine model. Design: Endoscopic animal experimental study of closure of colon perforation by using a porcine model. Subjects: Ten pigs were included in the study. Interventions: The Eagle Claw was used to close small perforations (1.5 to 2 cm) of the colon created by needle-knife with the animal under general anesthesia by using the endoluminal route. All animals received intravenous antibiotics and were allowed to eat after 24 hours. Main Outcome Measurements: The animals were monitored daily for signs of sepsis and peritonitis. On day 7, they were euthanized. The peritoneal cavity was examined for fecal peritonitis, and the colon perforation site was checked for wound dehiscence and pericolic abscess formation. Results: Endoscopic closure of the colon perforation was successful in 7 animals, and they recovered well without any sepsis or peritonitis. Necropsy did not reveal fecal peritonitis or pericolonic abscess formation at the site of perforation, and the perforation healed well. Closure was successful in 1 animal, but necropsy revealed dehiscence of the colon perforation site. Endoscopic closure was unsuccessful in 2 animals, and these were euthanized immediately. Conclusions: Closure of acute perforation of the colon is feasible with the Eagle Claw endoscopic suturing device in a porcine model.

Original languageEnglish (US)
Pages (from-to)113-119
Number of pages7
JournalGastrointestinal endoscopy
Volume64
Issue number1
DOIs
StatePublished - Jul 1 2006

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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