• Users Online:1377
  • Home
  • Print this page
  • Email this page
Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 
ORIGINAL ARTICLE
Year : 2014  |  Volume : 3  |  Issue : 4  |  Page : 226-231

Endoscopic ultrasound-assisted direct peritoneal visualization with a small-caliber scope: A proof of concept study in a swine model


1 Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Texas, USA; Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan
2 Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Texas, USA
3 Department of Neurosurgery, The University of Texas Medical School at Houston, Texas, USA
4 Department of Gastroenterology, Fukushima Medical University Aizu Medical Center, Aizuwakamatsu, Fukushima, Japan
5 Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Texas, USA
6 Department of Bioengineering, Rice University, Houston, Texas, USA
7 Department of Gastroenterology and Rheumatology, Fukushima Medical University School of Medicine, Fukushima, Japan

Correspondence Address:
Manoop S Bhutani
Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Texas
USA
Login to access the Email id

Source of Support: Dr. Bhutani is supported by Boston Scientifi c Investigator Sponsored Research Program. Dr. Suzuki is supported by a research grant from the Japanese Foundation for Research and Promotion of Endoscopy. Dr. Richards-Kortum is supported by NCI Cancer Center Support Grant (CA016672) and NIH grant 5R01 EB007594 and holds minority ownership of Remicalm, LLC as a scientifi c advisor. The endoscopic equipment was provided by Olympus Corporation of the America to MD Anderson Cancer Center for endoscopic research by any investigator., Conflict of Interest: None


DOI: 10.4103/2303-9027.144535

Rights and Permissions

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.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed1472    
    Printed23    
    Emailed0    
    PDF Downloaded303    
    Comments [Add]    
    Cited by others 1    

Recommend this journal