TITLE

SINGLE LUMEN ACCESS ANASTOMOSIS DEVICE FOR FLEXIBLE ENDOSCOPY

AUTHOR(S)
Fritscher-Ravens, A.; Mosse, A.C.; Mukherjee, D.; Mills, T.; Park, P.O.; Swain, C.P.
PUB. DATE
April 2003
SOURCE
Gut;Apr2003 Supplement 1, Vol. 52, pA24
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: Forming anastomoses between two lumens at flexible endoscopy might relieve obstruction and reduce the need for traumatic surgery. Current methods require access to both lumens. Aim: to develop methods of forming anastomosis at flexible endoscopy when access to only one lumen is feasibe, such as gastrojejunostomy in the presence of obstructing pancreatic cancer. Methods: A large channel echo-endoscope was used to image small intestine. A modified needle was passed from the accessible lumen into the target hollow organ. Out of four anastomosis devices designed one was chosen for extensive animal experiments. It was formed using two short 7F catheter segments attached together by a thread, which can be pushed over a wire into the target non-accessible lumen. They are released by withdrawing the guidewire to form a cross shape. These can form a cruciate anastomosis when compressed by a spring against a plate from the accessible side creating ischaemia. Results: These devices were tested on the bench in postmortem tissue and in live porcine tissue. In 18 pigs anastomoses were formed between small intestine and stomach and gall bladder and stomach. There were no complications. The size of the anastomoses were 3-8 mm. They underwent balloon dilatation and were patent 3-4 weeks after they had been formed at postmortem. In 8 of them an 11 mm gastroscope could pass through. Conclusion: It is feasible to form anastomoses at flexible endoscopy when access is limited to a single side.
ACCESSION #
9747417

 

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