TY - JOUR
T1 - Pilot study of transesophageal endoscopic surgery
T2 - NOTES esophagomyotomy, vagotomy, lymphadenectomy
AU - Woodward, Timothy
AU - McCluskey, David
AU - Wallace, Michael B.
AU - Raimondo, Massimo
AU - Mannone, John
AU - Smith, C. Daniel
PY - 2008/9/1
Y1 - 2008/9/1
N2 - Objectives: The aim of this study was to evaluate the technical feasibility of endosonographically-assisted transesophageal access for vagotomy, esophagomyotomy, and lymphadenectomy in a nonsurvival study with six porcine models in an animal laboratory with general anesthesia. Mehods: Saline/hydroxypropylmethylcellulose (HPMC) was injected into the submucosa with a subsequent biliary balloon dissection, creating a substantial submucosal space for a cap-fitted endoscope. A distal esophageal myotomy was performed after access into the thoracic cavity. Over the course of 6 pigs, esophagomyotomy (simulating a Heller myotomy), vagotomy, and lymphadenectomy were performed. The esophageal insertion/access site was sealed by the flap of mucosa. Results: Using a midesophageal entrance point, successful thoracic access and therapeutic interventions involving the esophagus and periesophageal structures were performed in 6 pigs. Conclusions: The submucosal saline/HPMC tunneling technique allowed for successful access to the upper mediastinum through the esophagus with feasible therapeutic interventions.
AB - Objectives: The aim of this study was to evaluate the technical feasibility of endosonographically-assisted transesophageal access for vagotomy, esophagomyotomy, and lymphadenectomy in a nonsurvival study with six porcine models in an animal laboratory with general anesthesia. Mehods: Saline/hydroxypropylmethylcellulose (HPMC) was injected into the submucosa with a subsequent biliary balloon dissection, creating a substantial submucosal space for a cap-fitted endoscope. A distal esophageal myotomy was performed after access into the thoracic cavity. Over the course of 6 pigs, esophagomyotomy (simulating a Heller myotomy), vagotomy, and lymphadenectomy were performed. The esophageal insertion/access site was sealed by the flap of mucosa. Results: Using a midesophageal entrance point, successful thoracic access and therapeutic interventions involving the esophagus and periesophageal structures were performed in 6 pigs. Conclusions: The submucosal saline/HPMC tunneling technique allowed for successful access to the upper mediastinum through the esophagus with feasible therapeutic interventions.
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U2 - 10.1089/lap.2008.0226
DO - 10.1089/lap.2008.0226
M3 - Article
C2 - 18803520
AN - SCOPUS:52449126982
SN - 1092-6429
VL - 18
SP - 743
EP - 745
JO - Journal of Laparoendoscopic and Advanced Surgical Techniques
JF - Journal of Laparoendoscopic and Advanced Surgical Techniques
IS - 5
ER -