Experimental endoscopic repair of gastric perforations with an omental patch and clips

Background. The omental patch is a standard surgical treatment of gastroduo denal ulcer perforation. This is a report of an experimental method for end oscopic repair of anterior gastric perforations with an omental patch devel oped by using a porcine model. Methods: A standardized gastric perforation was created in 10 pigs. The ome ntum was pulled Into the gastric lumen and fixed endoscopically to the musc ularis propria layer of the stomach with metallic clips. Results: The postoperative course was normal In 9 animals. An ulcer was evi dent at the site of repair at followup endoscopy. At autopsy, the omentum w as adherent to the external side of gastric wall. One animal died with peri tonitis, presumably because the muscularis propria layer could not be seen during the procedure, and the clips attached the omentum only to the mucosa . Conclusions: Endoscopic repair with an omental patch appears to be an effec tive procedure for closure of gastric perforations.