TY - JOUR
T1 - Transgastric ventral hernia repair
T2 - a controlled study in a live porcine model (with videos)
AU - Kantsevoy, Sergey V.
AU - Dray, Xavier
AU - Shin, Eun Ji
AU - Buscaglia, Jonathan M.
AU - Magno, Priscilla
AU - Assumpcao, Lia
AU - Marohn, Michael R.
AU - Redan, Jay
AU - Giday, Samuel A.
AU - Schweitzer, Michael A.
N1 - Funding Information:
DISCLOSURE: The following authors report that they have no disclosures relevant to this publication: E. J. Shin, J. M. Buscaglia, P. Magno, L. Assumpcao, M. R. Marohn, J. Redan, S. A. Giday, M. A. Schweitzer. The following authors have disclosed actual or potential conflicts: S. V. Kantsevoy, S. S. C. Chung, P. B. Cotton, C. J. Gostout, R. H. Hawes, A. N. Kalloo, and P. J. Pasricha are equity holders in Apollo Endosurgery, Inc (Austin, Texas). X. Dray received a grant from the French National Society for Gastroenterology (Société Nationale Française de Gastroentérologie, Robert Tournut Scholarship, 2006) and from the American Gastroenterological Association Foundation for Digestive Health and Nutrition (Jon I. Isenberg International Scholar Award, 2007) supporting his training and research in NOTES at Johns Hopkins University School of Medicine. The suture retrieving devices were provided for this study free of charge by Apollo Endosurgery, Inc (Austin, Texas), the T-bars were provided for this study free of charge by Cook Endoscopy (Winston-Salem, NC), and the mesh for the hernia repair was provided for this study free of charge by W. L. Gore and Associates, Inc (Flagstaff, Ariz).
PY - 2009/1
Y1 - 2009/1
N2 - Background: Ventral hernia repair is currently performed via open surgery or laparoscopic approach. Objective: To develop an alternative ventral hernia repair technique. Setting: Acute and survival experiments on twelve 50-kg pigs. Design and Interventions: An endoscope was introduced transgastrically into the peritoneal cavity. An abdominal wall hernia was created through a 5-mm skin incision followed by a 5-cm-long incision of the abdominal wall muscles and aponeurosis. A hernia repair technique was developed in 3 acute experiments. Then animals were randomized into 2 groups. In the experimental group (5 animals) Gore-Tex mesh was transgastrically attached to the abdominal wall, repairing the previously created abdominal wall hernia. In the control group (4 animals), the hernia was not repaired. In both groups, the endoscope was then withdrawn into the stomach, and the gastric wall incision was closed with T-bars. The animals survived for 2 weeks and were then euthanized. Main Outcome Measurement: The presence of ventral hernia on necropsy. Results: In the control group, the ventral hernia was present on necropsy in all animals. In the experimental group, the ventral hernia was easily repaired, with no evidence of hernia on necropsy. In the first animal in the experimental group, necropsy revealed infected mesh. After this discovery, we used sterilized cover for mesh delivery and did not find any signs of infection in 4 subsequent study animals. Limitation: The study was performed in a porcine model. Conclusions: Transgastric ventral hernia repair is feasible, technically easy, and effective. It can become a less invasive alternative to the currently used laparoscopic and surgical ventral hernia repair.
AB - Background: Ventral hernia repair is currently performed via open surgery or laparoscopic approach. Objective: To develop an alternative ventral hernia repair technique. Setting: Acute and survival experiments on twelve 50-kg pigs. Design and Interventions: An endoscope was introduced transgastrically into the peritoneal cavity. An abdominal wall hernia was created through a 5-mm skin incision followed by a 5-cm-long incision of the abdominal wall muscles and aponeurosis. A hernia repair technique was developed in 3 acute experiments. Then animals were randomized into 2 groups. In the experimental group (5 animals) Gore-Tex mesh was transgastrically attached to the abdominal wall, repairing the previously created abdominal wall hernia. In the control group (4 animals), the hernia was not repaired. In both groups, the endoscope was then withdrawn into the stomach, and the gastric wall incision was closed with T-bars. The animals survived for 2 weeks and were then euthanized. Main Outcome Measurement: The presence of ventral hernia on necropsy. Results: In the control group, the ventral hernia was present on necropsy in all animals. In the experimental group, the ventral hernia was easily repaired, with no evidence of hernia on necropsy. In the first animal in the experimental group, necropsy revealed infected mesh. After this discovery, we used sterilized cover for mesh delivery and did not find any signs of infection in 4 subsequent study animals. Limitation: The study was performed in a porcine model. Conclusions: Transgastric ventral hernia repair is feasible, technically easy, and effective. It can become a less invasive alternative to the currently used laparoscopic and surgical ventral hernia repair.
UR - http://www.scopus.com/inward/record.url?scp=58049191343&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=58049191343&partnerID=8YFLogxK
U2 - 10.1016/j.gie.2008.04.014
DO - 10.1016/j.gie.2008.04.014
M3 - Article
C2 - 19111690
AN - SCOPUS:58049191343
SN - 0016-5107
VL - 69
SP - 102
EP - 107
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 1
ER -