Hu B, Kalloo A N, Chung S S C, Cotton P B, Gostout C J, Hawes R H, Pasricha P J, Isakovich N V, Nakajima Y, Kawashima K, Kantsevoy S V
Eastern Hepatobiliary Hospital, Second Military Medical University of PLA, Shanghai, Ch.
Endoscopy. 2007 May;39(5):390-3. doi: 10.1055/s-2007-966426.
Multiple studies have demonstrated the feasibility of peroral transgastric endoscopic procedures in animal models. The aim of the study was to evaluate the feasibility of a peroral transgastric endoscopic approach to repair abdominal wall hernias.
We performed acute experiments under general anesthesia with endotracheal intubation using 50-kg pigs. Following peroral intubation an incision of the gastric wall was made and the endoscope was advanced into the peritoneal cavity. An internal anterior abdominal wall incision was performed with a needle knife to create an animal model of a ventral hernia. After hernia creation an endoscopic suturing device was used for primary repair of the hernia. After completion of the hernia repair the endoscope was withdrawn into the stomach and the gastric wall incision was closed with endoscopic clips. Then the animals were killed for necropsy.
Two acute experiments were performed. Incision of the gastric wall was easily achieved with a needle knife and a pull-type sphincterotome. A large (3 x 2 cm) defect of the abdominal wall (ventral hernia model) was closed with five or six sutures using the endoscopic suturing device. Postmortem examination revealed complete closure of the hernia without any complications.
Transgastric endoscopic primary repair of ventral hernias in a porcine model is feasible and may be technically simpler than laparoscopic surgery.
多项研究已证实在动物模型中经口经胃内镜手术的可行性。本研究的目的是评估经口经胃内镜修补腹壁疝的可行性。
我们使用50千克的猪，在气管插管全身麻醉下进行急性实验。经口插管后，切开胃壁，将内镜推进至腹腔。用针刀进行腹前壁内侧切口，以建立腹侧疝动物模型。造疝后，使用内镜缝合装置对疝进行一期修补。疝修补完成后，将内镜撤回胃内，用内镜夹封闭胃壁切口。然后处死动物进行尸检。
进行了两项急性实验。使用针刀和拉动式括约肌切开刀可轻松完成胃壁切开。使用内镜缝合装置用五六针缝合封闭了腹壁大（3×2厘米）缺损（腹侧疝模型）。尸检显示疝完全闭合，无任何并发症。
在猪模型中经胃内镜一期修补腹侧疝是可行的，且在技术上可能比腹腔镜手术更简单。
