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• W1999836564 abstract "Introduction: Current developments in intraluminal and natural orifice surgery are limited by issues of access, tissue manipulation, and approximation. This report describes an initial experience with a novel device for intraluminal manipulation and plication. Methods: The endoluminal system tested is comprised of a flexible, multilumen steerable access guide constructed using ShapeLock® Technology (TransPortTM) and a tissue approximation device (gProxTM) (USGI, San Clemente, CA). An adult pig was anesthetized and the stomach intubated using the access device preloaded with a standard Olympus gastroscope. The tissue approximation device was passed through the working channel, and under endoscopic visualization, manipulation of the gastric tissue was performed using a corkscrew type retractor, or using a combination of corkscrew retraction alternating with tissue grasping with the tissue approximation device, allowing tissue transfer or “hand over hand” type manipulation. Once an adequate and appropriate portion and location of tissue were so controlled, the tissue approximation device was used to place preloaded low-profile anchor pairs into the tissue and perform a secured plication under endoscopic guidance. Multiple maneuvers were performed in the area of the cardia via a retroflexed approach, and in the more distal stomach via an antegrade approach. The animal was euthanized at procedure completion and the plication sites examined. Results: Two endoscopists new to the device were able to place 6 anchor pairs in rapid fashion. The tissue manipulation capability was facile with both the corkscrew retractor and hand over hand approach. The plication sites revealed full thickness or deep muscularis tissue incorporation at all sites. In the cardia area, this created a ridge of thick, deep folds along a concentric line below the gastroesophageal junction. Conclusion: The gProx approximation device is a novel endoluminal tool which, in concert with the TransPort access platform, can allow endoluminal manipulation and plication of deep muscular or full thickness tissue anywhere within the gastric lumen. Further study of the device's utility and durability in augmenting the area of the angle of His or achieving other types of gastric tissue approximation endoluminally is warranted." @default.
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• W1999836564 date "2006-04-01" @default.
• W1999836564 modified "2023-09-25" @default.
• W1999836564 title "Initial Experience with a Novel Endoscopic Device Allowing Intragastric Manipulation and Plication" @default.
• W1999836564 doi "https://doi.org/10.1016/j.gie.2006.03.101" @default.
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