Inflammatory Response to NOTES Transgastric Surgery

Study Aim: The risk of gastric spillage during transgastric surgery is a concerning potential complication of NOTES procedures. The aim of this study is to determine the risk of sepsis from gastric spillage in a rat survival model by measuring local and systemic inflammatory markers, adhesive disease, and clinical outcomes.
Methods: Under IACUC approval, mini-laparotomy with needle aspiration of either 2cc of gastric contents (study group SG) or sterile saline (control group CG) was injected into the peritoneal cavity of 60 male 250g Sprague-Dawley rats. Animals were kept alive for 14 days, and sacrificed at different time intervals to assess intra-peritoneal inflammation. Inflammatory markers (TNFa, IL-6 and IL-10) were analyzed by ELISA assay and obtained at 1, 6, and 24 hours post-operatively by obtaining plasma levels and peritoneal washings. Animals were clinically assessed for weight gain, regular bowel movements, and level of activity. At necropsy, the peritoneal cavity was examined grossly for adhesions and graded from 1 (mild) to 3 (severe) based on the severity.
Results: There were 2/60 (3%) deaths among the rats in the survival group ranging from 3-14 days. One died from peritonitis and one from unknown causes. The remaining survivors in the SG gained an average of 13g/week post-operatively compared to the CG that gained 16g/week (p>0.05). No significant difference was seen in bowel movements or level of activity between the two groups. There was a statistically significant difference in the amount of adhesions between the control and study groups, .33 vs.1.58, (p

Session: Podium Presentation

Program Number: S020

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