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- Title
Full-thickness laparoendoscopic colonic excision in an experimental model.
- Authors
Brigic, A.; Southgate, A.; Sibbons, P.; Clark, S. K.; Fraser, C.; Kennedy, R. H.
- Abstract
Background Patients requiring surgery for complex colonic polyps traditionally undergo colectomy, with significant risks. Typically in excess of 10-30 cm of colon is removed at laparoscopic or open surgery lasting over 60 min. This study details the preclinical development of a rapid, minimally invasive, limited full-thickness colonic resection. Methods Both survival and non-survival procedures were performed in anaesthetized 70-kg pigs. A simulated colonic polyp was created by endoscopic ink injection with a clearance margin delineated by circumferential placement of mucosal argon plasma coagulation marks. Full-thickness eversion of the bowel was achieved using endoscopically placed anchors and the polyp was excised using a laparoscopic stapler. In survival procedures, pigs were killed under anaesthetic 8 days after surgery. All pigs underwent post-mortem examination. Results Five procedures were performed (5 pigs). The median (range) procedure duration was 26 (20-31) min, with a specimen diameter of 5·1 (4·5-6·3) cm. The postoperative recovery of survival animals (4 pigs) was uneventful. At post-mortem evaluation the resection sites were well healed with no evidence of stenosis, intra-abdominal infection or inadvertent organ damage. Histological assessment of anastomoses showed mucosal repair and restoration of submucosal continuity. Conclusion Full-thickness localized colonic excision with this technique provides a large specimen with adequate healing in a porcine model. Presented to the Annual Meeting of the Association of Surgeons of Great Britain and Ireland, Glasgow, UK, May 2013; published in abstract form as Br J Surg 2013; 100(Suppl 7): 2
- Subjects
ENDOSCOPIC surgery; COLON surgery; POLYPS; BLOOD coagulation; MEDICAL sciences; LABORATORY swine; PATIENTS; THERAPEUTICS
- Publication
British Journal of Surgery, 2013, Vol 100, Issue 12, p1649
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1002/bjs.9298