Percutaneous Closure of Gastrostomy Using a Suture-Mediated Vascular Closure Device in a Swine Model

Abstract

Purpose After any procedure through the percutaneous gastrostomy (PG), a PG tube should be kept in place until a mature tract develops. For this period of maturation which takes about 2 to 4 weeks, tube dislodgement, leakage, or peritonitis can occur. Complications from PG tube maintenance can be prevented by closing the PG immediately after the procedure. The purpose of this study was to evaluate the feasibility and safety of immediate PG closure using Perclose ProGlide. Materials and Methods A 2-week survival study was performed in a swine model. We applied one Perclose ProGlide device for closing a 13-Fr PG (n = 3) and two devices for closing a 20-Fr PG (n = 3). Body weight, temperature and laboratory findings were observed. Autopsy and microscopic examination were performed after 2 weeks. Results All the swine subjects did not demonstrate any sign of systemic inflammatory responses in terms of fever and laboratory findings. From autopsy results, five pigs showed complete healing of the PG. One pig that underwent 20-Fr gastrostomy site closure with double Perclose ProGlide had scanty semitransparent fluid in the peritoneal cavity but that was not indicative of inflammation. En bloc tissue samples from all the pigs demonstrated complete wound healing of the PG sites. Conclusion Percutaneous application of single or double Perclose ProGlide devices is feasible and safe for the PG closure in a swine model.