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Published in: Surgical Endoscopy 1/2024

Open Access 20-11-2023 | Dynamic Manuscript

A novel twin-grasper assisted mucosal inverted closure technique for closing large artificial gastric mucosal defects

Authors: Qinbo Cai, Huanjie Chen, Haobin Hou, Wenqing Dong, Lele Zhang, Minxuan Shen, Shaoxiong Yi, Rongman Xie, Xun Hou, Wentong Lan, Yulong He, Dongjie Yang

Published in: Surgical Endoscopy | Issue 1/2024

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Abstract

Background

Large artificial gastric mucosal defects are always left unclosed for natural healing due to technique difficulties in closure. This study aims to evaluate the feasibility and safety of a new Twin-grasper Assisted Mucosal Inverted Closure (TAMIC) technique in closing large artificial gastric mucosal defects.

Methods

Endoscopic submucosal dissection (ESD) was performed in fifteen pigs to create large gastric mucosal defects. The mucosal defects were then either left unclosed or closed with metallic clips using TAMIC technique. Successful closure rate and the wound outcomes were assessed.

Results

Two mucosal defects with size of about 4.0 cm were left unclosed and healed two months after surgery. Thirteen large gastric mucosal defects were created by ESD with a medium size of 5.9 cm and were successfully closed with the TAMIC technique (100%), even in a mucosal defect with a width up to 8.5 cm. The mean closure time was 59.0 min. Wounds in eight stomachs remained completely closed 1 week after surgery (61.5%), while closure in the other five stomachs had partial wound dehiscence (38.5%). Four weeks later, all the closed defects healed well and 61.5% of the wounds still remained completely closed during healing. There was no delayed perforation or bleeding after surgery. In addition, there was less granulation in the submucosal layer of the closed wound sites than those under natural healing.

Conclusions

The present study suggests that TAMIC is feasible and safe in closing large artificial gastric mucosal defects and could improve mucosal recovery compared to natural healing process.
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Metadata
Title
A novel twin-grasper assisted mucosal inverted closure technique for closing large artificial gastric mucosal defects
Authors
Qinbo Cai
Huanjie Chen
Haobin Hou
Wenqing Dong
Lele Zhang
Minxuan Shen
Shaoxiong Yi
Rongman Xie
Xun Hou
Wentong Lan
Yulong He
Dongjie Yang
Publication date
20-11-2023
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 1/2024
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-023-10552-6

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