Full-thickness laparoendoscopic colonic excision in an experimental model.

Abstract

BACKGROUND:

Patients requiring surgery for complex colonic polyps traditionally undergo colectomy, with significant risks. Typically in excess of 10-30 cm of colon is removed at laparoscopic or open surgery lasting over 60 min. This study details the preclinical development of a rapid, minimally invasive, limited full-thickness colonic resection.

METHODS:

Both survival and non-survival procedures were performed in anaesthetized 70-kg pigs. A simulated colonic polyp was created by endoscopic ink injection with a clearance margin delineated by circumferential placement of mucosal argon plasma coagulation marks. Full-thickness eversion of the bowel was achieved using endoscopically placed anchors and the polyp was excised using a laparoscopic stapler. In survival procedures, pigs were killed under anaesthetic 8 days after surgery. All pigs underwent post-mortem examination.

RESULTS:

Five procedures were performed (5 pigs). The median (range) procedure duration was 26 (20-31) min, with a specimen diameter of 5.1 (4.5-6.3) cm. The postoperative recovery of survival animals (4 pigs) was uneventful. At post-mortem evaluation the resection sites were well healed with no evidence of stenosis, intra-abdominal infection or inadvertent organ damage. Histological assessment of anastomoses showed mucosal repair and restoration of submucosal continuity.

CONCLUSION:

Full-thickness localized colonic excision with this technique provides a large specimen with adequate healing in a porcine model.

• Authors: A Brigic, A Southgate, P Sibbons, S K Clark, C Fraser, R H Kennedy
• Journal: The British journal of surgery (Br J Surg) Vol. 100 Issue 12 Pg. 1649-54 (Nov 2013) ISSN: 1365-2168 [Electronic] England
• PMID: 24264790 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 British Journal of Surgery Society Ltd. Published by John Wiley & Sons Ltd.

Topics

• Anastomosis, Surgical (methods)
• Animals
• Colon (surgery)
• Colonic Polyps (surgery)
• Colonoscopy (methods)
• Constriction
• Disease Models, Animal
• Laparoscopy (methods)
• Postoperative Period
• Surgical Stapling
• Sus scrofa
• Wound Healing (physiology)