Percutaneous transgastric endoscopic tube ileostomy in a porcine survival model

Figure 1 Step-by-step procedure of pelvis-directed submucosal tunneling endoscopic gastrostomy. A: Gastric mucosal incision; B: Submucosal tunneling; C: Seromuscular incision.

Figure 2 Step-by-step procedure of endoscopic tube ileostomy. A: Endoscopic identification of the distal ileum in the left lower quadrant; B: Endoscopic view of a loop of the distal ileum on its anti-mesenteric side grasped and held to the anterior abdominal wall; C: Percutaneous terminal ileum puncture; D: Endoscopic view of the distal ileum sutured to the abdominal wall with two stitches; E: Endoscopic view of the inflated balloon in the ileal lumen; F: Accomplished tube ileostomy.

Figure 3 An endoscopic view of gastrostomy closure with endoloop ligation.

Figure 4 Gross and histopathological evaluation of gastrostomy closure 1 wk after natural orifice transgastric endoscopic surgery. A: Gross examination showing complete healing of gastrostomy; B: Histopathological examination showing complete healing of gastrostomy.

Figure 5 Gross and histopathological evaluation of stoma tract formation of the ileostomy 1 wk after natural orifice transgastric endoscopic surgery. A: Gross examination showing adequate stoma tract formation of ileostomy; B: Histopathological examination showing adequate stoma tract formation of ileostomy.