The role of endoscopic ultrasound in transgastric interventions with flexible endoscope. Experimental results

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

Zsirka-Klein A. 1 , Lukovich P. 1 , Winternitz T. 1 , Tari K. 1 , Kupcsulik P.

15th United European Gastroenterology Week (UEGW) in Paris, France 27-29 October 2007

Endoscopy 2007; 39 (Suppl I) A191

1 1st Department of Surgery, Semmelweis University, Budapest, Hungary


INTRODUCTION: Numerous questions need to be answered before the Natural Orifice Transluminal Endoscopic Surgery can be applied regularly. The stomach is an ideal organ for transluminal surgery: the hazard of bacterial contamination is low and it has a strong tendency for recovery. Its large lumen makes it possible, though within certain limits, to choose the gastrotomy orifice corresponding to the organ to be operated. At the same time it can be experienced in percutan endoscopic gastrostomy that due to the gastric ligaments and the neighbouring organs, the needle will not always turn up at the expected location in the endoscopy. It is also a well-known fact that the right position of the trocars in laparoscopic operations is extremely important.

AIMS & METHODS: Our working group carried out gastro-enterostomy, cholecystectomy, appendectomy and ligation of tuba on biosynthetic models using traditional instruments. In the technical implementation of our experiments, we found several times that despite the gastrointestinal tract of the pig fixed according to the anatomic situation, the spot for gastrotomy was not defined with the necessary accuracy in the gastroscopy. For this reason we carried out an endoscopic ultrasound examination of the model dipped into 0.9% NaCl solution in order the make the intraluminal orientation easier and to define the exact spot of the gastrotomy orifice. The ideal spot for the purpose of the surgery was marked with an electrocauther.

RESULTS: The internal organs could be localized on the biosynthetic model by means of the endoscopic ultra sound examination, but we could not enhance accuracy to the necessary extent.

CONCLUSION: The endoscopic ultrasound may be of help in the localization of the gastrostomy, but it is not enough as an independent method.