Percutaneous Transgastric Technique for Creating Gastroenteric Anastomoses in Swine

Constantin Cope, Hans A. Timmermans, Barry Uchida, Dusan Pavcnik

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

PURPOSE: To develop a percutaneous transgastric procedure for creating a stent-containing gastroenteric anastomosis (GEA). MATERIALS AND METHODS: Acute experiments were performed on eight pigs. A 10-F gastroduodenostomy sheath was used to insert guide wires and targeting devices in the retrogastric jejunal loop; a 6.5-F sheathed trocar needle was then introduced through a second gastric sheath to puncture and catheterize the jejunum through the back of the stomach. Two special sliding anchor pairs were introduced through the catheter to "sandwich" the gastric sheath to the jejunal wall. The jejunum was catheterized a third time between the anchor sets to create a GEA tract for insertion of a stent. The animals were killed at various periods as long as 1 month after the experiments. RESULTS: Snares were the most useful targeting devices for jejunal puncture. Single (n = 1) and double (n = 7) anchor-pair staples effectively prevented intraperitoneal leakage during and after insertion of 12-mm or 14-mm stents. Necropsy of six healthy animals at 5 days, 7 days, 14 days, and 4 weeks (n = 3) showed well-developed patent GEA anastomoses. There was one anesthetic death; one animal was killed at 4 days for obstructive ileus after a difficult transgastric jejunal catheterization. CONCLUSIONS: A GEA can be fashioned through a percutaneous gastrostomy with stapling anchors. This technique may have clinical applications for managing gastric outlet obstruction.

Original languageEnglish (US)
Pages (from-to)177-181
Number of pages5
JournalJournal of Vascular and Interventional Radiology
Volume15
Issue number2 I
StatePublished - Feb 2004

Fingerprint

Stents
Stomach
Swine
Jejunum
Punctures
Gastric Outlet Obstruction
Equipment and Supplies
Gastrostomy
Ileus
Surgical Instruments
Catheterization
Needles
Anesthetics
Catheters

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Percutaneous Transgastric Technique for Creating Gastroenteric Anastomoses in Swine. / Cope, Constantin; Timmermans, Hans A.; Uchida, Barry; Pavcnik, Dusan.

In: Journal of Vascular and Interventional Radiology, Vol. 15, No. 2 I, 02.2004, p. 177-181.

Research output: Contribution to journalArticle

Cope, Constantin ; Timmermans, Hans A. ; Uchida, Barry ; Pavcnik, Dusan. / Percutaneous Transgastric Technique for Creating Gastroenteric Anastomoses in Swine. In: Journal of Vascular and Interventional Radiology. 2004 ; Vol. 15, No. 2 I. pp. 177-181.
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