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  • Title: Laparoscopic azygoportal disconnection procedure with a bipolar feedback controlled sealing system in a porcine model.
    Author: Shamiyeh A, Hubmann R, Benkö L, Vattay P, Röth E, Tulipan L, Wayand WU, Danis J.
    Journal: J Surg Res; 2006 Jan; 130(1):8-12. PubMed ID: 16289598.
    Abstract:
    BACKGROUND: To examine the feasibility of a new, minimally invasive procedure for the devascularization of the proximal stomach and distal esophagus to prevent recurrent variceal bleeding in portal hypertension in a new animal model. MATERIAL AND METHODS: Portal hypertension was created by laparoscopic clip ligation of the portal vein on 20 pigs. After 2 weeks the azygoportal disconnection procedure was performed with the LigaSure-ATLAS instrument. RESULTS: There were 16 pigs out of 20 that survived both operations. Two died during introduction of anesthesia, one because of a cardiac arrest (second operation). One pig died resulting from necrosis of the gastric and esophageal wall. Autopsy (2 weeks later) showed that there was a complete arterial devascularization. At autopsy, none of the remaining 16 pigs had esophageal varices or necrosis of the stomach or esophagus. CONCLUSION: Laparoscopic azygoportal disconnection is a less invasive method for the prevention of rebleeding and seems to be safely performed with the LigaSure-ATLAS instrument.
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