Animal study of adhesiolysis via transumbilical endoscopic surgery with gastric endoscopy: an exploration.

Abstract

BACKGROUND AND AIMS: Adhesive intestinal obstruction is a common clinical condition caused by obstruction of the intestinal contents. Adhesiolysis is an effective treatment, but traditional open or laparoscopic adhesiolysis is traumatic and often causes a recurrence of adhesions. In this study, we investigate the feasibility and safety of adhesiolysis via transumbilical endoscopic surgery (TUES) with a gastric endoscopy. METHODS: Eight beagles were used to establish a model of adhesive intestinal obstruction through open simulated surgery. TUES adhesiolysis with a gastric endoscopy was performed 2 weeks later. The time of adhesiolysis, vital signs of beagles, intraoperative hemorrhage, intraoperative and postoperative complications were recorded and analyzed. Three months later, the abdominal cavity was re-explored to observe whether there were recurrences of adhesions, abdominal infections, and other complications. RESULTS: The modeling of all 8 beagles was successfully achieved in the formation of adhesive intestinal obstruction, and the TUES adhesiolysis was successfully completed. The median (interquartile range) time of adhesiolysis was 83(9) minutes. The vital signs of the beagles were stable, and there were no adverse events, including heavy bleeding, perforation, or mortality during the operation. All 8 beagles survived without postoperative complications such as delayed bleeding, peritonitis, intra-abdominal abscess, and abdominal wall incisional hernia three months after adhesiolysis. CONCLUSION: TUES adhesiolysis has been preliminarily proven to be minimally invasive, safe, and effective, which provides a new option for adhesive intestinal obstruction.