METHODS: We performed OAGB with NOTES approach in 3 human cadavers. The steps of the procedure can be divided as follows: step 1, endoscopic sleeve gastroplasty (ESG); step 2, trans-gastric access to peritoneal cavity; step 3, identification of suitable loop of jejunum; step 4, introduction of the jejunal loop into the stomach; step 5, creation of the gastro-jejunostomy with lumen-apposing metal stent (LAMS); step 6, gastric pylorus occlusion with overstitch.
RESULTS: We performed OAGB with NOTES in 3 human cadavers with bypassed bilio-pancreatic limb of 55, 75, and 105 cm from the pylorus. The average weight for the cadavers was 64.9 kg (61.2-71.7 kg). The mean procedure time was 157 min. The optimal bypassed length for the procedure was 105 cm.
CONCLUSIONS: This study has provided proof-of-principle in a pre-clinical cadaveric model that NOTES approach can be used to perform OAGB and, therefore, merits additional evaluation and consideration in surviving porcine model.
方法:我们在3个人类尸体中使用NOTES方法进行了OAGB。该程序的步骤可分为以下步骤:步骤1,内窥镜套管式胃成形术(ESG);步骤2,经胃进入腹膜腔;步骤3,确定合适的空肠环;步骤4,将空肠环引入胃中;步骤5,使用管腔贴壁金属支架(LAMS)创建胃空肠造口术;步骤6,胃幽门闭塞过度缝合。
结果:我们在距幽门55、75和105厘米旁路的3具人类尸体中使用NOTES进行了OAGB。尸体的平均体重为64.9kg(61.2-71.7kg)。平均手术时间为157分钟。该程序的最佳旁路长度为105cm。
结论:这项研究在临床前尸体模型中提供了原理证明,NOTES方法可用于执行OAGB,因此,值得在存活的猪模型中进行额外的评估和考虑。