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Z-shaped incision enhances minimally-invasive surgery
Date:12/17/2007

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The key to their approach lies in the way the flexible probe exits the stomach. Instead of cutting straight through the stomach wall the researchers guide the endoscope so that it first tunnels under the mucous membrane of the stomach wall for a while before exiting near an organ to be operated on. The endoscope essentially charts a Z-shaped path.

This new technique, known as STAT (self-approximating transluminal access technique), has two main advantages according to Moyer. There is significantly less bleeding involved and the Z-shaped tract effectively seals itself due to pressure created on the abdominal wall by normal breathing.

The team published its findings in a recent issue of Gastrointestinal Endoscopy.

The technique has other advantages as well. "Most people operate straight through the gastric wall and then use a bunch of complex maneuvers to get the endoscope where it needs to be," said Pauli. "And it can get difficult to operate because the endoscope is upside down and in a reverse position."

By tunneling through instead, he points out, doctors can maintain a directional sense and guide the endoscope more accurately.

"There are landmarks in the mucous membrane such as specific blood vessels and groupings of blood vessels. We can also see through the wall of the stomach in some areas to guide the endoscope to the organ we want to operate on," Pauli said.

The researchers have so far operated on 17 animals and only one of them has developed a minor complication.

Once they have perfected their tunneling technique, Moyer and colleagues will try to figure out how exactly to remove surgical specimens from an operation.

"The gall bladder, small tumors, even the ovaries are potentially removable through this technique," said Mathew. "We could in theory make the tunnel as big as we want, and take something out into the stomach and cut it into small pieces before extracting it."

If successful, the procedure
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Contact: Amitabh Avasthi
axa47@psu.edu
814-865-9481
Penn State
Source:Eurekalert

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