Anonymous User
Login / Registration

a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2011; 65(4): 207-210.

Feasibility of a novel single loop-and-clip gastrotomy closure ("King's closure") after NOTES procedures in an experimental study

Ondřej Ryska  1, Jan Martínek  2,3, Radek Doležel  4, Tereza Filípková  5, Štefan Juhás  6, Jana Juhásová  7, Miroslav Zavoral  8, Inna Tučková  9, Miroslav Ryska10

+ Affiliation


The NOTES (Natural Orifice Transluminal Endoscopic Surgery) technique has recently been the subject of many experimental and several clinical trials. A safe access site closure (e.g. gastrotomy) is essential for its widespread application. The aim of our experimental study was to evaluate the feasibility and safety of a novel single loop-and-clip ("King's closure") gastrotomy closure technique. A single loop-and-clip closure was performed in 24 pigs after different transgastric procedures (peritoneoscopy, liver biopsy, ovariectomy, and cholecystectomy). A two-channel endoscope was used in all cases. Gastrotomy was performed using a needle knife followed by balloon dilatation. A single endoloop (30 mm) fixed around the gastrotomy with standard clips was used for a closure. Animals were euthanized after 30 days and autopsy was performed. The median closure time was 8 minutes and 4.5 clips were used on average. Small intra-abdominal abscesses were found in 8 (33%) animals and 15 (63%) animals had several avascular adhesions. A healed serosa-to-serosa gastrotomy closure was found in all animals confirmed by histological examination. The new single loop-and-clip gastrotomy closure ("King's closure") is a fast, feasible and safe technique using standard accessories.


To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users

Credited self-teaching test