Long-term successful closure of a percutaneous intragastric trocar tract with crossing full-thickness sutures in a porcine model

Abstract

Abstract Background and study aims A novel intragastric trocar placed using a percutaneous endoscopic gastrostomy technique enables the use of laparoscopic tools and procedures, including tissue stapling, cutting, suturing, and retraction. The aim of this porcine study was to determine long-term success of crossing full-thickness sutures in closure of the tract upon trocar withdrawal. Methods 10 trocars were placed in 5 animals. Each animal underwent a standardized tissue resection using a 5-mm stapler under gastroscopic guidance, and two full-thickness, absorbable, crossing sutures were used to close the trocar tracts. The animals were monitored for 35 days and then euthanized for necropsy. Results All five animals survived without sign of infection or distress. Nine of the 10 trocar sites healed completely without any adverse findings. A single site developed a gastrocutaneous fistula. On necropsy, there was no evidence of intra-abdominal infection or abscess. Conclusions Full-thickness crossing sutures appeared to be effective in long-term closure of an intragastric trocar tract. Given the ease of placement and success of this simple closure method, this device may prove clinically useful to the endoscopist performing complex procedures in the endoscopy suite.