LAPAROSCOPIC MODIFIED SUGIURA PROCEDURE - EXPERIMENTAL-STUDY ON THE PIG

Background. The Sugiura procedure is an alternative treatment for blee ding gastroesophageal varices. Laparoscopic Sugiura procedure has not previously been described. The aim of this study is to develop a lapar oscopic oesophageal transection with an EEA stapler, as well as a comp lete laparoscopic modified Sugiura procedure. Methods. We used six fem ale farm pigs weighing 30-50 kg. Six trocars were used. The steps of t he procedure are: 1) mobilization of the lower oesophagus and truncal vagotomy; 2) oesophageal resection-anastomosis with an EEA stapler; 3) devascularization of the corpus and fundus of the stomach and the low er 10 cm of the oesophagus; 4) splenectomy; 5) Nissen fundoplication; 6) pyloroplasty.Results. The mean operation time was 180 min, while th e mean blood loss 260 ml. All staple lines are integral during autopsy at the end of the procedure. Conclusions. Laparoscopic oesophageal tr ansection with an EEA stapler as well as a complete laparoscopic modif ied Sugiura procedure are feasible.