# Single-port flexible endoscopic enterolysis under the guidance of electromagnetic navigation in a hypochlorite-induced abdominal adhesions pig model

## TL;DR

Researchers tested a new minimally invasive technique using electromagnetic navigation to safely remove abdominal adhesions in pigs.

## Contribution

This study introduces single-port flexible endoscopic enterolysis guided by electromagnetic navigation in a pig model of abdominal adhesions.

## Key findings

- Seven out of eight fibrous bands were successfully dissected using the technique.
- The procedure duration averaged 48 minutes, with sufficient visibility in most cases.
- One case had intraoperative bleeding due to mesenteric artery damage.

## Abstract

Small bowel obstruction (SBO) usually resolves with medical therapy but requires surgery, preferentially under the guidance of laparoscopy. We performed single-port flexible endoscopic enterolysis for abdominal adhesions under the guidance of dual-channel electromagnetic navigation technology and evaluated the feasibility and safety of this method in a pig model.

Hypochlorite-induced abdominal adhesions was induced in 8 pigs. A long gastric tube with a magnetic navigation wire (sensor 1) was inserted into the distal end of the small intestine. The electromagnetic signal emitter was activated, and a second magnetic navigation wire (sensor 2) was continuously adjusted on the abdominal surface to obtain the two coordinates closest to the incised skin. The trocar was placed, and pneumoperitoneum was established. An endoscope with a second wire was placed through the trocar, and diagnostic intraperitoneal endoscopy was performed. The fibrotic bands and peritoneal congestion were observed, and the fibrous bands were dissected with a Dual knife.

Abdominal adhesions model was evaluated. One case experienced intraoperative bleeding because the small mesenteric artery was damaged. Both the peritoneum and operating space were sufficiently visible in all cases except one, in which intestinal inflation significantly affected visibility. Seven of 8 (87.5%) of fibrous bands were successfully dissected. The total procedure duration was 48 (35–60) mins. Compared with that in the hypochlorite-induced abdominal adhesions model, weight gain was 6 (4–9) kg.

Flexible endoscopy adhesiolysis under the guidance of electromagnetic navigation for abdominal adhesions is comparatively safe and feasible.