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In vivo assessment of gastrotomy closure with over-the-scope clips in an experimental model for varicocelectomy

2009Journal article Open access
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dc.contributor.authorRolanda, C
dc.contributor.authorLima, E
dc.contributor.authorSilva, D
dc.contributor.authorMoreira, I
dc.contributor.authorPêgo, JM
dc.contributor.authorMacedo, G
dc.contributor.authorCorreia-Pinto, J
dc.date.accessioned2012-06-29T12:36:40Z
dc.date.available2012-06-29T12:36:40Z
dc.date.issued2009
dc.description.abstractBACKGROUND: Gastrotomy closure remains the major limiting factor for human translation of transgastric surgery; the over-the-scope clip (OTSC) system was proposed as a possibility for this purpose. Transgastric access is good for a pelvic approach, making varicocelectomy a possible indication for natural orifice transluminal endoscopic surgery (NOTES). OBJECTIVE: To evaluate the reliability of the OTSC system in vivo after transgastric testicular vessel ligation (varicocelectomy model). DESIGN: There were 3 experimental groups (5 animals in each): groups 1 and 3, gastrotomy dilation up to 18 mm, surgery was performed with a double-channel endoscope; group 2, gastrotomy dilation up to 13 mm, surgery was performed with a single-channel endoscope. SETTING: Surgical Sciences Research Domain, Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal. INTERVENTIONS: Bilateral testicular vessel ligation by transgastric access. Gastrotomy closed with the largest version of OTSC system (12 mm): a single clip in groups 1 and 2, and 2 clips in group 3. Animals were monitored for 2 weeks, killed, and submitted for necropsy. MAIN OUTCOME MEASUREMENTS: Adequacy of closure and healing after the use of the OTSC system. Statistical analysis. RESULTS: Vessel ligation was easily achieved in all groups. Although differences in the complication rate did not reach statistical significance (P = .099), there was a clear tendency for a better prognosis in groups 2 and 3 than group 1. In fact, only 2 animals from group 1 had complications related to incomplete gastrotomy closure. LIMITATIONS: Small number of animals per group; nonrandomized study. CONCLUSIONS: The OTSC system was shown to be easy and efficient for gastrotomy closure in a survival experimental model of varicocelectomy, when correctly matching the gastrotomy size with the clip size and/or number.por
dc.identifier.citationGastrointest Endosc. 2009;70(6):1137-45por
dc.identifier.urihttp://hdl.handle.net/10400.23/292
dc.language.isoengpor
dc.peerreviewedyespor
dc.publisherElsevierpor
dc.subjectAnimaispor
dc.subjectGastroscopiapor
dc.subjectEstômagopor
dc.subjectProcedimentos Cirúrgicos Urológicos Masculinospor
dc.subjectVaricocelopor
dc.titleIn vivo assessment of gastrotomy closure with over-the-scope clips in an experimental model for varicocelectomypor
dc.typejournal article
dspace.entity.typePublication
rcaap.rightsopenAccesspor
rcaap.typearticlepor

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