Feasibility of thoracoscopic U-clip esophageal anastomosis: an alternative for esophageal atresia reconstruction

J Pediatr Surg. 2004 Jun;39(6):851-4. doi: 10.1016/j.jpedsurg.2004.02.023.


Background: The authors propose that U-Clips can significantly decrease the technical difficulty of performing thoracoscopic esophageal reconstruction, thus, reducing operating time, the incidence of postoperative leak, and stricture rate.

Methods: After obtaining Institutional Animal Care and Use Committee approval, 3 4-kg female piglets underwent complete thoracoscopic esophageal transections. The esophagus was reconstructed thoracoscopically using S50 and S60 U-Clips over an 8F transanastomotic tube. Esophagrams were performed on postoperative day (POD) 7, 21, 44, and 77.

Results: Mean operating time was 57 minutes (45 to 75 min). Two of 3 piglets had no evidence of leak on POD 7 esophagrams. One animal had a small leak that resolved spontaneously on antibiotics. All 3 piglets tolerated a formula diet orally by POD 8. Over a 77-day survival period all 3 piglets had steady weight gain on an oral diet.

Conclusions: U-Clips are a feasible alternative to sutures for esophageal reconstruction in thoracoscopic surgery. Further study is warranted to investigate the full potential of U-Clips in minimally invasive pediatric surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Anastomosis, Surgical / instrumentation
  • Animals
  • Disease Models, Animal
  • Esophageal Atresia / surgery*
  • Esophagoplasty / instrumentation*
  • Esophagus / surgery*
  • Feasibility Studies
  • Female
  • Minimally Invasive Surgical Procedures
  • Sus scrofa
  • Thoracoscopy / methods*