The Experimental Animal Research of Peroral Endoscopic Tunnel Technique in Diagnosis and Treatment of the Diseases Around Abdomen Aorta

Abstract

Introduction: The emergence of endoscopic tunnel technique makes many diseases which used to need surgical or laparoscopic surgical treatments entered into the endoscopic therapy. The tunnel technique could well prevent the communication between the intra-luminal and the extra-luminal space by sealing the entry incision of the tunnel, gas or fluid within the lumen was prevented from entering the extra-luminal space, which could ensure the endoscopic therapy free of perforation. The procedure is endoscope penetrate from body's natural orifices such as esophagus, gastric, rectum, vagina and so on to body cavity for treatment. But there are few bottlenecks in the development of NOTES. First, it is difficult to close the entrance of natural orifices. Second, the infection which is caused by liquid and air of natural orifices enter into body cavity would occur. Third, it would be lost in body cavity. This research use endoscopic tunnel techniques to perform NOTES in experimental pigs, The tunnel will resolve the problem of closing entrance and infection. Methods: Established an esophagus submucosal tunnel about 5cm long to cardia at the back wall in pigs, Full-thickness myotomy performed and endoscope entered into abdominal cavity through the muscle incision. Exhaust air by puncturing into abdominal cavity. Partial hepatectomy and splenectomy, around the celiac artery ganglion neurolysis, partial tissue resection in the aera of posterior peritoneum were performed. Experimental pigs were prohibited water and diet intake and took antibiotics for 5 days. Their survival situations were observed. Three days later, experimental pigs were executed and were opened to observe the structures of abdominal cavity. Results: Experimental pigs were died after operating splenectomy. Experimental pigs were alive after successfully operating other surgeries. Three days later experimental pigs were executed and were found no injuries in other organs, but adhesion to different degrees of tissues in surgery position. Extensive intra-abdominal endoscopic therapy couldn't be carried out with limit of current endoscopic equipment. Conclusion: Partial hepatectomy and splenectomy, around the celiac artery ganglion neurolysis and partial tissue resection in the area of posterior peritoneum were all successfully performed in experimental animals through endoscopic tunnel technique and the complications were under controlled by internal medicine treatments.