New minimal invasive method for creation of gastro-entero anastomosis. Experimental results on byosintetic model

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

Kecskédi B. Lukovich P. Zsirka-Klein A. Tari K. Jónás A. Váradi G.Kádár B.Kupcsulik P.

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

Endoscopy 2007; 39 (Suppl I) A352



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

INTRODUCTION: The most frequent reason for the gastric outlet obstruction is the cancer of the head of the pancreas. The gold standard of palliative therapies in this condition is the surgical gastro-entero anastomosis. There are several minimal invasive methods (laparoscopic GEA, duodenal stent implantation), but the complications (anastomosis insufficiency, stent migration and obstruction) are relatively common after these procedures. In the last few years two new methods were developed for creation of gastro-entero anastomosis: one of them uses magnets, the other one makes the anastomosis by endoscope on transgastric way (NOTES). The transgastric method needs narcosis and the patient could be fed after 3-4 days. The creation of the GEA with magnets could be carried out without general narcosis, but for the development of the anastomosis 10-14 days are needed.

AIMS & METHODS: The aim of our study was to develop a new method of creation gastro-entero anastomosis, which could be executed without narcosis, and by way of it the patient could be fed immediately. Previously we successfully created GEA even only transgastric way and buy using magnets as well. Experiment were carried out on biosynthetic model, which was made by using the gastrointestinal tract of a slaughtered domestic pig. Compounding the advantages of the two new methods, we created a flexible iron ring, which was introduced thought the gastric wall into the first jejunal loop by direct punction. After it a rare-earth magnet ring was placed into the stomach in front of the iron ring. They were mated transmurally, so the stomach and jejunal walls were fixed together. The procedure was guided by EUS.

RESULTS: Making connection between the metal ring and the magnet was performed successfully. Anastomosis could be created immediately on the size of the internal diameter of the rings. Although the rings were mated, the match of the tissues was not exact and safe enough.

CONCLUSION: The method - after further developments - could be useful in the treatment patients suffering from gastric outlet obstruction.