Artikel
Ensdoscopic closure of a chronic gastrocutaneous fistuale with the Apollo Overstich suture device
Suche in Medline nach
Autoren
-
Sascha Chopra
- Charité Campus Virchow Klinikum, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Berlin, Deutschland
-
Tido Junghans
- Klinikum Bremerhaven Reinkenheide, Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Bremerhaven, Deutschland
-
Johann Pratschke
- Charité Campus Virchow Klinikum, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Berlin, Deutschland
-
Ricardo Zorron
- Charité Campus Virchow Klinikum, Klinik für Allgemein-, Visceral- und Transplantationschirurgie, Berlin, Deutschland
| Veröffentlicht: | 21. April 2016 |
|---|
Gliederung
Text
Background: Chronic gastrocutaneous fistula is a rare clinical condition usually addressed by open or laparoscopic surgery. An innovative endoscopic suture system (Apollo Overstich®) allows full-thickness running sutures of the gastric wall. We demonstrate the first case of successful closure of a chronic gastrocutaneous fistula.
Materials and methods: A 49-years-old patient suffered from complicated chronic ethilic pancreatitis and developed e chronic gastrocutaneous fistula after internal drainage of pancreatic pseudocysts and many reoperations for bleeding and intraabdominal Abscesses. External wound control with vacuum therapy and secondary wound closure remained futile, after 5months the patient still had a high volume outlet fistula with total parenteral nutrition. A novel endoscopic suture device was applied and connected to a double channel endoscope. The sutures (polypropylene 2-0) were placed endoscopically through a 2-channel gastroscope under direct vision.
Results: After application of an endoscopic sutures with the Apollo Overstich® system the gastric wall defect was permanently sealed. The patient was discharged 3 days after the intervention. Regular outpatient controls after 6 months showed no signs of a recurrence.
Conclusion: The concept of endoscopic full-thickness sutures was successfully applied in a chronic gastrocutaneous fistula. This novel technique needs further evaluation and may reduce the rates of surgical interventions in this complex disease.
