Endoscopic Ultrasound-assisted Direct Peritoneal Visualization with a Small-caliber Scope: A Proof of Concept Study in a Swine Model

Overview

Journal Endosc Ultrasound

Date 2014 Dec 9

PMID 25485270

Citations 2

Authors

Rei Suzuki

Manoop S Bhutani

Dongsuk Shin

Atsushi Irisawa

Jason B Fleming

Rebecca Richards-Kortum

Hiromasa Ohira

Affiliations

Soon will be listed here.

Abstract

Background: Laparoscopic and natural orifice transluminal endoscopic surgery techniques can diagnose peritoneal findings that suggest tumor cell dissemination. However, they have not been incorporated into routine practice, mainly owing to their complexity. To develop a minimally invasive endoscopic technique for the diagnosis of peritoneal findings, we conducted feasibility study using an acute swine model.

Materials And Methods: This study involved six domestic pigs. Trans-gastric access to the peritoneal cavity was performed utilizing an endoscopic ultrasound fine needle aspiration (EUS-FNA) technique. After dilation of the needle hole with a biliary dilatation catheter and balloon, a small-caliber scope was inserted into the peritoneal cavity. Peritoneal images were obtained with the scope and a high-resolution microendoscope (HRME). Main outcome measurements were technical feasibility and time needed to access the peritoneal cavity.

Results: Direct visualization of the peritoneum was successful in all six pigs and gained access to the gross appearance of the peritoneal cavity. HRME imaging with topical contrast agent also obtained reasonable quality images representing nuclei of the peritoneal mesothelium. Average operation time from the initiation of EUS-FNA to acquiring peritoneal images was 26.5 min (range 15-40 min). Autopsy found no damage to the adjacent organs, and stomach wall defects were tightly closed with hemostasis clips.

Conclusion: EUS-assisted direct peritoneal visualization with small-caliber scope is technically feasible. HRME may assist in the diagnosis of findings on the peritoneum.

Citing Articles

Endoscopic ultrasound-guided fine needle aspiration for pancreatic cancer.

Suzuki R, Takagi T, Sugimoto M, Konno N, Sato Y, Irie H Fukushima J Med Sci. 2018; 64(3):111-115.

PMID: 30197399 PMC: 6305789. DOI: 10.5387/fms.2018-14.

Diagnosis of lymphoma by endoscopic ultrasound-assisted transendoscopic direct retroperitoneal lymph node biopsy: A case report (with video).

Guo J, Sun B, Wang S, Ge N, Wang G, Wu W Endosc Ultrasound. 2015; 4(1):69-72.

PMID: 25789289 PMC: 4362009. DOI: 10.4103/2303-9027.151368.

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