Endoscopic Treatment for Gastric Perforation Using T-tag and Plastic Protection Chamber

Background: The endoscopic gastric perforation is a consequence of some endoscopic procedures and now a way to manage abdominal organs. This is the reason why endoscopists are studying a safe endoscopic repair.
Methods: Ten White Landrace pigs underwent a gastric perforation of 1.8cm in diameter under general anesthesia. The opening was repaired with stitch assembled in a T-tag anchor placed through the gastric wall with a needle. A plastic transparent chamber, adapted to the endoscope tip protected the abdominal organs from the needle puncture outside the stomach. 6 T-tags were placed in most cases and the stitches were tied with a metallic tie-knot, forming three sutures. The animals received liquids in the same operative day. One shoot antibiotic was used. The leakage test was performed with a forceps and by air distention.
Results: No complication was detected in the postoperative course. One month later endoscopy revealed a scar and some suture material was observed in all animals. Few adhesions were found in the laparotomy performed in the same time. The adhesions were intense in an animal in which a cholecystectomy was performed before the repair.
Comments: The devices used in the repair here described were very simple and cheap and allowed very good results. Despite the attachment of the walls by the mucosa few adhesions were found in most cases.
Conclusion: The endoscopic repair using T-tag and a protector chamber is feasible, easy to perform and safe. Further studies are needed to show the real value of this kind of procedure

Session: Video Channel

Program Number: V065

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