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Huberty V, Leclercq L, Hiernaux M, Verset L, Sandersen C, Beyna T, Neuhaus H, Deviere J. Endoscopic full-thickness resection using an endoluminal-suturing device: a proof-of-concept study. Endosc Int Open 2019; 7:E1310-E1315. [PMID: 31673599 PMCID: PMC6805186 DOI: 10.1055/a-0860-5387] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 02/14/2019] [Indexed: 02/07/2023] Open
Abstract
Background and study aims Endoscopic full-thickness resection (EFTR) is used to achieve R0 resection in difficult situations and as a way to overcome the limitations of endoscopic submucosal dissection. Multiple techniques have been described but adequate tools are still under evaluation. In this study, we evaluated the safety and feasibility of non-exposed endoscopic full-thickness resection using a novel endoscopic suturing device. Materials and methods Full-thickness resections of gastric predetermined lesions were performed on five pigs using the Endomina platform. After creating virtual lesion > 20 mm, sutures were placed around it using this triangulation platform. After tightening the knots, the bulging lesion, internalized into the gastric lumen, was cut with a needle knife. Results R0 resections of large lesions (42 to 60 mm) were achieved in all cases. One perforation occurred and prompted us to improve the procedure by shortening the sutures for more maneuverability and reinforcing the suture line before section. Procedure duration dropped by 50 % between the first case and the fourth case. Histological analysis confirmed successful full-thickness resection of all resected specimens. Conclusion EFTR using this triangulation platform seems feasible for lesions > 20 mm. Additional possible improvements were identified to simplify the procedure before moving to human trials.
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Affiliation(s)
- Vincent Huberty
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium,Corresponding author Vincent Huberty, MD Erasme Hospital, ULB, CP572/10Route de lennik 8081070 BrusselsBelgium+0032 2 555 46 97
| | | | | | - Laurine Verset
- Department of Anatomopathology, Erasme Hospital, Université Libre de Bruxelles, Belgium
| | | | - Thorsten Beyna
- Department of Gastroenterology, Evangelisches Krankenhaus, Dusseldorf, Dusseldorf, Germany
| | - Horst Neuhaus
- Department of Internal Medicine, Evangelisches Krankenhaus, Dusseldorf, Dusseldorf, Germany
| | - Jacques Deviere
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Lonys L, Vanhoestenberghe A, Huberty V, Hiernaux M, Cauche N, Julémont N, Debelle A, Huberland F, Acuña V, Godfraind C, Devière J, Delchambre A, Mathys P, Deleuze S, Nonclercq A. In Vivo Validation of a Less Invasive Gastrostimulator. Artif Organs 2018; 41:E213-E221. [PMID: 29148134 DOI: 10.1111/aor.13056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Gastrointestinal stimulator implants have recently shown promising results in helping obese patients lose weight. However, to place the implant, the patient currently needs to undergo an invasive surgical procedure. We report a less invasive procedure to stimulate the stomach with a gastrostimulator. After attempting fully endoscopic implantation, we more recently focused on a single incision percutaneous procedure. In both cases, the challenges in electronic design of the implant are largely similar. This article covers the work achieved to meet these and details the in vivo validation of a gastrostimulator aimed to be endoscopically placed and anchored to the stomach.
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Affiliation(s)
- Laurent Lonys
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Anne Vanhoestenberghe
- Aspire Centre for Rehabilitation Engineering and Assistive Technology, Department of Materials and Tissue, University College London, Stanmore, United Kingdom
| | - Vincent Huberty
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Erasme University Hospital, Brussels, Belgium
| | | | - Nicolas Cauche
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Nicolas Julémont
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Adrien Debelle
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - François Huberland
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Vicente Acuña
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Carmen Godfraind
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Jacques Devière
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Université Libre de Bruxelles, Erasme University Hospital, Brussels, Belgium
| | - Alain Delchambre
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Pierre Mathys
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
| | - Stefan Deleuze
- Départment des Sciences Cliniques-Clinique Equine, Université de Liège, Liège, Belgium
| | - Antoine Nonclercq
- Bio, Electro and Mechanical Systems Department, Université Libre de Bruxelles, Brussels, Belgium
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Huberty V, Ibrahim M, Hiernaux M, Chau A, Dugardeyn S, Devière J. Safety and feasibility of an endoluminal-suturing device for endoscopic gastric reduction (with video). Gastrointest Endosc 2017; 85:833-837. [PMID: 27562938 DOI: 10.1016/j.gie.2016.08.007] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 08/05/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Obesity is a major pandemic disease. Surgical therapy is highly effective, but its availability will likely be overwhelmed by the burden of the disease. Endoscopic technologies that could reproduce some of the clinical effects of surgery may become part of the treatment armamentarium. A simple transoral restrictive procedure could play a role in first-line surgical management. METHODS We evaluated the safety and feasibility of transmural suturing using a simple triangulation platform for gastric volume reduction through the creation of multiple double plicatures. RESULTS Between May and July 2015, 11 obese (body mass index 34.6 ± 2.1 kg/m2) patients (mean age, 36 ± 10 years) underwent gastroplasty through transmural endoscopic sutures (performed using a triangulation platform and an endoscopic stitcher). The median duration of the procedure was 2.00 hours (range, 1.15-3.15 hours) and dramatically decreased after the first 5 cases. No severe adverse events were observed. Mean (standard deviation) weight loss and percentage of excess weight loss were 5.8 kg (2.7%) and 21% (9%) at 1 month (n = 11), 8.8 kg (4.9%) and 33% (22%) at 3 months (n = 10), and 10.9 kg (7.3%) and 41% (33%) at 6 months (n = 10). CONCLUSIONS Transoral endoscopic gastroplasty performed using a simple triangulation platform and a dedicated suturing device appears to be safe and effective at mid-term follow-up in creating gastric restriction and inducing weight loss in this first-in-humans experience. (Clinical trials registration number: NCT02534662.).
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Affiliation(s)
- Vincent Huberty
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Mostafa Ibrahim
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | - Sonia Dugardeyn
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Jacques Devière
- Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Lonys L, Vanhoestenberghe A, Huberty V, Hiernaux M, Cauche N, Julémont N, Debelle A, Huberland F, Acuña V, Godfraind C, Devière J, Delchambre A, Mathys P, Nonclercq A. Design and Implementation of a Less Invasive Gastrostimulator. Eur J Transl Myol 2016; 26:6019. [PMID: 27478566 PMCID: PMC4942709 DOI: 10.4081/ejtm.2016.6019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gastrointestinal stimulator implants have recently shown positive results in helping obese patients lose weight. However, to place the implant, the patient currently needs to undergo an invasive surgical procedure. Our team is aiming for a less invasive procedure to stimulate the stomach with a gastrostimulator. Attempts covered fully endoscopic implantation and, more recently, we have focussed on a single incision laparoscopic procedure. Whatever the chosen implantation solution, the electronic design of the implant system shares many challenges. This paper covers the work achieved to meet these.
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Radermecker MA, Jastrzebska V, Hiernaux M, Canivet JL, Limet R. [Image of the month. Aortic quadricuspid, a rare cause of aortic insufficiency]. Rev Med Liege 2005; 60:75-6. [PMID: 15819367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- M A Radermecker
- Service de Chirurgie Cardio-Vasculaire et Thoracique, CHU du Sart-Tilman
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Berthe C, Pierard LA, Hiernaux M, Trotteur G, Lempereur P, Carlier J, Kulbertus HE. Predicting the extent and location of coronary artery disease in acute myocardial infarction by echocardiography during dobutamine infusion. Am J Cardiol 1986; 58:1167-72. [PMID: 3788803 DOI: 10.1016/0002-9149(86)90376-0] [Citation(s) in RCA: 260] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The feasibility, safety and usefulness of 2-dimensional echocardiography (2-D echo) during dobutamine infusion for identifying patients with multivessel coronary artery disease (CAD) after acute myocardial infarction (AMI) were evaluated in 30 patients 5 to 10 days after AMI. Patients underwent 2-D echo under basal conditions and during dobutamine infusion at each dose from 5 to a maximum of 40 micrograms/kg/min, limited multilead submaximal bicycle exercise testing and coronary and left ventricular angiography. Echocardiograms were analyzed independently by 2 observers. The test response was considered positive if abnormal wall motion and reduced myocardial thickening were observed during dobutamine infusion in vascular distributions other than the area of infarction identified during basal conditions. Exercise testing was considered positive when more than 1 mm of ST depression occurred 80 ms after the J point. Dobutamine stress testing was well tolerated; no complications and no significant arrhythmia were observed. Echocardiographic recordings were adequate in all patients during the entire test; the concordance in interpretation between the 2 observers was perfect for the prediction and location of ischemic segments during dobutamine infusion. In 15 of 17 patients without multivessel CAD, no asynergy was observed outside the infarct zone during dobutamine infusion (specificity 88%). In 11 of 13 patients with multivessel CAD, new wall motion abnormalities were identified in the segments corresponding to the arterial lesions diagnosed by angiography (sensitivity 85%).(ABSTRACT TRUNCATED AT 250 WORDS)
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Pieters G, Van Den Spiegel A, Hiernaux M, Demeester P. ["Thoracic outlet syndrome" with aneurysm of the subclavian artery]. Tunis Med 1973; 51:327-30. [PMID: 4802112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Hiernaux M. [Theoretical basis for physical training in ischemic cardiopathies]. Rev Med Liege 1973; 28:643-4. [PMID: 4751554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Andriange M, Hiernaux M, Gach J, Lisin N, Carlier J. [Practical modalities of physical training of cardiac patients]. Rev Med Liege 1973; 28:645-6. [PMID: 4751555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Gach J, Hiernaux M, Lisin N, Andriange M, Calay G, Carlier J. [Recent therapeutic developments in the treatment of myocardial infarction]. Rev Med Liege 1973; 28:635-42. [PMID: 4148043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Lisin N, Andriange M, Calay G, Gach J, Hiernaux M, Mbuyamba P, Vandenbosch R, Boxho G, Claessens JJ, Zicot M, van Herck A, Carlier J. [3 years of existence of a coronary care unit]. Rev Med Liege 1973; 28:631-4. [PMID: 4751553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Rorive G, Hiernaux M. [On the use of antimitotic and immunosuppressive agents in nephrology]. Rev Med Liege 1969; 24:699-705. [PMID: 5403554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Salmon J, Lambert PH, Hiernaux M. [Intravascular coagulation and anaphylactic phenomena]. Nouv Rev Fr Hematol 1968; 8:76-83. [PMID: 4232154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Radermecker M, Cornette M, Hiernaux M, Libon JC, Boverie M. [Clinical study of the action of a circulatory analeptic, H 835, in states of severe shock following medical diseases]. Rev Med Liege 1966; 21:337-40. [PMID: 5928749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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