A possible method of decreasing bleeding and infection risk in the course of transgastric surgery

Szülőkategória: KUTATÁSI TÉMÁK
10. 01. 09
Módosítás: 01 december 2016

Kadar B., 1 , Lukovich P .,2 , Kurt G., 3 , Varadi G., 1 , Jonas A., 1 , Csicsai L., 1 ,Huba A., 4 , Kupcsulik P.

Magyar Gasztroenterológiai Társaság 49. Nagygyűlése, Tihany, 2007. június 1-6.

Absztrakt: Z Gastroenterol. 2007 May; 45(5)

Faculty of Medicine 6th year, Semmelweis University, Budapest, Hungary 1 ,

1st Dept. of Surgery, Semmelweis University, Budapest, Hungary 2 ,

Technische Universitat Ilmenau, Ilmenau, Germany 3,

Budapest University of Technology, Budapest, Hungary 4



Introduction: During the last years many people expressed their doubts whether the rapid development of minimal invasive transgastric surgery increased the risk of bleeding and infection. To solve the problem the literature recommends the use of antibiotic washout, sterile instruments and overtube. So far there has been no specially designed overtube for the transgastric technique. Aim: To design and produce an overtube which overcomes the challenges.

Method : Our device was tested on the gastrointestinal tract of a slaughtered pig. The length of the tube was 70 cm , the diameter was 3 cm , and the thickness of its wall was 0.5 mm . It was made of silicon. The overtube was compressed parallel to the longitudinal axis and put into a cover. On the gastric end of the overtube there were two separately inflatable ring-formed balloons to fix the tube to the stomach wall. With a needle knife an incision was made on the gastric wall, through which we managed the compressed end of the overtube into the abdominal cavity. The cover was pulled back and the distal balloon was blown up. With minor force the overtube was moved back while the distal balloon stretched to the outer surface of the gastric wall. From the proximal balloon the cover was removed and it was also blown up. With the help of the overtube a Fallopian tube ligation was performed.

Result: Using the overtube we led two flexible endoscopes quickly and safely into the abdominal cavity, moreover, other instruments could also be used and exchanged without any difficulties. The injury of the esophagus could be avoided. With the use of the overtube as a consequence of the compression and closure between the two balloons the risk of bleeding and infection can be reduced. An insufflator can be attached to the overtube so the abdominal pressure becomes measurable. An unexpected result was that as the overtube gave greater rigidity to the instruments the performance of the tube ligation was easier and faster.

Conclusion : To lower the risks even further besides the use of specially designed surgical instruments other subsidiary devices are also needed.