Evaluation of feasibility, efficiency and safety of a pure NOTES gastrojejunal bypass with XXXX , in an in vivo porcine model.

@entity1707 @entity353 @entity254 @entity1084 @entity1017 @entity298
INTRODUCTION: Natural orifice transluminal endoscopic surgery (NOTES) gastrojejunal @entity254 (GJA) is a less invasive surgery for bariatric procedures and @entity1084 . The aim of this study was to evaluate the feasibility, efficacy, and safety of a pure NOTES gastrojejunal bypass using an in vivo porcine model. MATERIAL AND METHODS: A prospective study was performed on nine @entity1707 . A double-channel scope was used. The intervention steps were: (i) gastric incision; (ii) peritoneal access; (iii) jejunal loop selection and mobilization into the stomach; (iv) stoma creation within the gastric wall and incision; (v) @entity254 suture and pylorus closure using a T-tag prototype. The animals were assessed clinically for 3 weeks including the @entity1017 . The patency of the GJA was assessed at necropsy and a histological analysis was performed. RESULTS: We successfully performed all the procedures with a mean (standard deviation [SD]) operative time of 108 (26) minutes. We used a mean of 5.55 (1.30) stitches. There were no intraprocedural adverse events. Five animals survived up till euthanasia at 3 weeks (65%). These showed a significant difference in weight curves of a loss of 3.2kg compared with gain of 5.2kg in a control group.Four @entity1707 died from anastomotic dehiscence complicated by @entity298 . CONCLUSION: Gastrojejunal bypass with a pure NOTES approach is feasible. This procedure is effective, resulting in a patent @entity254 and a significant @entity353 . However, the anastomotic dehiscence is a major concern because of its mortality rate, and further studies including improvement of the suturing device and the technique are needed.
