Post written by Andrew C. Storm, MD, from the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA.
A tool commonly used in laparoscopic surgeries is the articulating stapler. This allows for efficient tissue removal or remodeling with the push of a button.
As miniaturization permitting a stapler to fit through a scope’s working channel is unlikely, alternative means of bringing this useful tool into the GI tract have been considered.
In this preclinical feasibility study, a simple trocar (Endo-TAGSS), placed similar to a pull-gastrostomy tube, allowed for articulating laparoscopic stapling at the GE junction for fundoplication across the GE junction for myotomy and in the body of the stomach for gastroplasty.
Minimally invasive endoscopic therapy for common conditions such as gastroesophageal reflux disease (GERD), obesity, and removal or ablation of premalignant and malignant gastrointestinal lesions represents a growth area for endoscopy. This transgastric trocar was evaluated and found to be simple and effective at achieving multiple interventions within the stomach, giving endoscopists access to the coveted laparoscopic stapler.
Ongoing evaluation of the Endo-TAGSS device will more clearly define the role it will play in managing common gastrointestinal disease such as GERD.
Endo-TAGSS components. A, Cannula with a removable headpiece with a monofilament loop and an internal bumper. B, External disc to secure the cannula against the anterior abdominal wall before surgical instrumentation. C, Endoscopic-laparoscopic intragastric trocar with a self-sealing cap.
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