Snare-assisted flexible endoscope in trans-gastric endoscopic gallbladder-preserving surgery: A pilot animal study

Figure 1 Snare-assisted flexible endoscope in transgastric endoscopic gallbladder-preserving surgery. A: The anterior wall of the gastric antrum was incised; B: The snare was placed on the transparent cap (red arrow); C: The endoscope was inserted into the abdominal cavity. The gallbladder was located; D: The transparent cap clung to the gallbladder wall, and the gallbladder wall was sucked in it. The snare was released, and the gallbladder wall was ligated; E: This ligation state was maintained; F: The gallbladder wall was incised with the assistance of the snare; G: With the navigation of the snare, the endoscopist quickly found the gallbladder and gallbladder incision again (blue arrow); H: With the help of the snare, clips were used to close the gallbladder wall incision; I: The snare was loosened (yellow array); J: The gallbladder wall returned to normal.

Figure 2 Overall multivariate analysis of all subjects in the control group vs the snare-assisted group. The workload for each subscale was significantly less when using snare-assisted compared with control group (^aP < 0.05). Lower performance workload subscores corresponded to an improvement in perceived performance. NASA-TLX: National Aeronautics and Space Administration-Task Load Index.

Figure 3 The livers of animals in the control group had electric burn scars (arrow). A: The electric burn scars were farther from the gallbladder; B: The electric burn scars were near the gallbladder.

Figure 4 Gastroscopic review and necropsy were performed 28 d after the operation. A: The gastric wall incision healed well, with some clips remaining; B-D: A small number of adhesions appeared around the gallbladder incision, and the metal clip was wrapped in it; E: The gallbladder mucosa at the original incision healed well; F: The local mucosa surface was slightly edematous (red circle).