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KMID : 0931320130130030167
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대한상부위장관.헬리코박터학회지
2013 Volume.13 No. 3 p.167 ~ p.172
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Percutanous Ultrathin Flexible Peritoneoscopy for Detecting Peritoneal Metastasis: A Feasibility Study
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Kim Min-Su
Kwon Hea-Yoon
Bang Byoung-Wook
Kim Hyung-Gil
Kwon Kye-Sook
Shin Yong-Woon
Jeong Seok
Lee Don-Haeng
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Abstract
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Background/Aims: Preoperative diagnosis of peritoneal metastasis is extremely important to select the appropriate treatment strat-egy and predict the prognosis for patients with gastrointestinal cancer. However, imaging techniques have a limited capacity for de-tecting peritoneal metastasis. We therefore evaluated the feasibility of percutaneous ultrathin flexible peritoneoscopy in an animal model.
Materials and Methods: Percutanous ultrathin flexible peritoneoscopy was performed on two mini-pigs under general anesthesia. We punctured the abdominal wall at the anti-Mcburney and umbilical regions using a 16-gauge angiocatheter. Guidewire was in-serted through the angiocatheter and we then enlarged the puncture using a biliary dilation catheter and a 6- to 8-mm balloon dilator catheter. After track formation, we inserted a 4.9-mm ultrathin endoscope into the abdominal cavity. The peritoneal cavity was ex-amined, and peritoneal and liver biopsy was performed. The puncture was closed with a single suture. After the procedure, we moni-tored the general condition of the pigs for 2 weeks.
Results: Percutaneous ultrathin flexible peritoneoscopy was successfully performed regardless of the puncture site location. Peritoneal and liver biopsy was also successfully executed. The mean procedure time was 20 minutes. Formation of the abdominal track was not easily accomplished with standard endoscopic equipment. Nevertheless, none of the abdominal organs were injured. The post-procedure course was uneventful. Minor scarring was observed at the incision site 2 weeks after the procedure.
Conclusions: Percutanous ultrathin flexible peritoneoscopy is a relatively simple and technically feasible method. However, dedi-cated accessories for fascial dilation should be developed to ensure the safety of human patients undergoing this procedure.
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KEYWORD
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Laparoscopy, Endoscopes, Peritoneum, Feasibility studies
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