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Endoluminal Closure Device

Endoluminal Closure Device. Braham Dhillon Ali Hales Laura Mattaliano John Sticklen. Abdominal Surgery. Most surgeries in the peritoneal cavity currently require incision through the abdomen New development: Natural Orifice Transluminal Endoscopic Surgery (NOTES)

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Endoluminal Closure Device

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  1. Endoluminal Closure Device Braham Dhillon Ali Hales Laura Mattaliano John Sticklen

  2. Abdominal Surgery • Most surgeries in the peritoneal cavity currently require incision through the abdomen • New development: Natural Orifice Transluminal Endoscopic Surgery (NOTES) • NOTES – Using an endoscope, create a hole in the stomach wall (gastrotomy) to gain access to peritoneal cavity to perform surgery

  3. Our Project • Problem: Currently there is no way to reliably seal the gastrotomy. • Objective: Develop a device to close a gastrotomy after a NOTES procedure – stitch, clamp, staple or otherwise seal • Benefits: incisionless surgeries, quicker recovery time (??)

  4. Advisers • Mike Holzman, M.D., M.P.H. Gastrointestinal surgery, laparoscopic procedures • Gus Attwell, M.D. general gastroenterology • Alan Herline, M.D. colo rectal surgery

  5. The Stomach • An external system • Digestion of food • A lot of acid and pepsin • 1st layer: thick layer of mucus • 2nd layer: antacid bicarbonate • 3rd layer: tight cell surface and folds • Perforation: hole in stomach • Severe pain, shock & hardening of wall • Bleeding into digestive tract Reference: http://www.yourdictionary.com/images/ahd/jpg/A4stomac.jpg

  6. Gastroscope • A long, thin, flexible fiber optic tube with light and a camera attached • Used to examine the lining of the upper GI tract • Diagnosis and treatment of -bleeding -cancers -hiatal hernia -removal of swallowed objects -abnormalities • Biopsy taken with miniature foreceps or thin wire-loop snare Reference: http://www.gihealth.com/html/test/gastroscopy.html

  7. Laparoscope • A slender tubular endoscope • Used to look at a patients abdomen or pelvis (appendix, liver, gallbladder, fallopian tubes, ovaries etc) • Small incision though which probes and other instruments are introduced. • Smaller incisions, faster recovery time, cost effective, less risky. Reference: http://www.nlm.nih.gov/medlineplus/ency/imagepages/1109.htm

  8. Current Accomplishments • Meetings with Dr. Holzman • Parameters of Incision • 2 cm length, Stomach wall thickness 3-5 mm • Heal within 7-14 days • Current and Potential methods • Videos • Endoscopic Surgery • Potential Solutions • Observation of Hernia Surgery • Examination of Equipment • Preliminary Research

  9. Current Plan • December 6th – Meet with Dr. Attwell • Endoscope • With CAD drawings • Requested in December • GI Mentor • Dr. Caroline Cao • Virtual reality program, simulates gastrointestinal system • Currently discussing appointment times

  10. Future Plans • Explore the feasibility of using materials with “shape memory” - Nitinol - Thermoplastic polymers • Determine methods of testing procedure - Materials with properties of stomach - Testing on animal stomachs

  11. Nitinol • Equal mixture of nickel and titanium • Shape of material dependent on temperature • Coil • Push through

  12. Thermoplastic Polymer • Has been shown to tie itself into a knot • Absorbed by the body • Engineered to retain memory of specific shape • Transforms into that shape when heated to body temperature • Polymers that respond to UV light

  13. Questions

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