Endoscopic full-thickness closure of large gastric perforations by use of tissue anchors

BackgroundA flexible needle-catheter tissue-anchoring device was developed to accomplish full-thickness tissue apposition of the GI wall. The aim of this study was to identify the performance of this device for repair of large iatrogenic gastric perforations in a porcine model.ObjectivesSix pigs.DesignShort-term survival animal study.SettingsPigs were studied while they were under general anesthesia. Device performance in differing gastric locations and wall thicknesses was assessed by 2 perforations more than 2 cm in size created for each pig along the greater curvature and the anterior wall.InterventionsEach perforation was closed by parallel placement of tissue anchor sets sequentially along the length of the perforation.Main Outcome MeasurementsOne week follow-up endoscopy and necropsy were performed.ResultsTwelve perforations were closed with the 48 tissue anchor sets. All animals survived for 1 week without clinical complications. Follow-up endoscopy and necropsy revealed that all tissue anchors remained with firmly held sutures and sealed perforations.ConclusionsFull-thickness closure with a new tissue-anchoring device simply and successfully repaired large iatrogenic gastric perforations.