A live animal model of major haemorrhage using an implanted short gastric artery was devised to test the efficacy and safety of these endo-suture devices in vivo. Pulsatile arterial bleeding was successfully reproduced in eight pigs' stomachs through incision of the pre-buried vessels. Endoscopic suturing controlled the bleeding in all animals without obvious complications. The mean operating time with the Eagle Claw V was statistically shorter than that with the Eagle Claw II machine (3.6 verse 13.8 minutes, p<0.001). / A vessel-perfusion-manometry system was first established incorporating porcine stomach and splenic artery with the Erlangen model. / From these investigations, it is concluded that (1) Both the vessel-perfusion-manometry system and the animal arterial haemorrhage model are reliable, reproducible and realistic methods suitable for endoscopic experiment in the laboratory settings. (2) Either three-throw knot tied endoscopically or intracorporeal endo-loop ligation can secure vessels as large as 2mm in diameter enduring flow pressure greater than 200 mmHg. (3) It is possible to control massive arterial bleeding in stomach with endoscopic suturing using the novel apparatus with a curved needle. (4) The Eagle Claw V represents significant improvement over previous version, and is associated with ease of operation and higher security, which brings the technique closer to clinical applications. (Abstract shortened by UMI.) / Peptic ulcer remains the most common cause of upper gastrointestinal haemorrhage. Existing endoscopic haemostatic modalities cannot securely control massive ulcer bleeding from large eroded vessels. A well-designed endoscopic suturing device has the possibility to plicate large artery. In addition, it may provide enormous potential in other forms of endo-surgery. A novel suturing device using a curved needle, the Eagle Claw, was developed. The aims of this thesis were to evaluate the efficacy and safety of the Eagle Claw II and V in arresting artificial gastric bleeding from large vessel in a laboratory setting. These devices were tested both in vitro on the bench and in vivo in live animal models. / Hu Bing. / "August 2005." / Adviser: Ng Ekw. / Source: Dissertation Abstracts International, Volume: 67-07, Section: B, page: 3694. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 136-160). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.

by Lau Wan Yee, Joseph. / Thesis (M.D.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 145-189). / Title Page --- p.1 / Dedication --- p.2 / Table of Contents --- p.3 / Hypotheses --- p.7 / Precis to the thesis --- p.8 / List of Publications of my research work used in this thesis --- p.19 / List of Figures --- p.25 / List of Tables --- p.26 / Acknowledgments --- p.27 / Statement of Originality --- p.28 / Chapter PART I --- HISTORICAL REVIEW --- p.30 / Chapter Chapter 1 --- History of Endoscopic and Laparoscopic Surgery --- p.31 / Chapter 1.1 --- History of Endoscopic Surgery --- p.31 / Chapter 1.2 --- History of Documentation of Endoscopic and Laparoscopic Surgery --- p.38 / Chapter 1.3 --- History of Laparoscopic Surgery --- p.39 / Chapter 1.4 --- The future of Endoscopic and Laparoscopic Surgery --- p.52 / Chapter Chapter 2 --- History of Perforated Peptic Ulcer --- p.53 / Chapter PART II --- SIZE OF THE PROBLEM --- p.57 / Chapter Chapter 1 --- Incidence of Feptic Ulcer in Different Parts of The World --- p.58 / Chapter Chapter 2 --- Incidence of Peptic Ulcer in Hong Kong 1970 -1993 --- p.60 / Chapter Chapter 3 --- Incidence of Perforated Peptic Ulcer --- p.70 / Chapter 3.1 --- Incidence of Perforated Peptic Ulcer in Different Parts of The World --- p.70 / Chapter 3.2 --- Incidence of Perforated Peptic Ulcer in Hong Kong --- p.71 / Chapter 3.3 --- "Incidence of Perforated Peptic Ulcer in Prince of Wales Hospital, Hong Kong" --- p.71 / Chapter PART III --- CURRENT TREATMENT OF PERFORATED PEPTIC ULCER --- p.74 / Chapter Chapter 1 --- Recent Developments in Treatment of Uncomplicated Peptic Ulcer --- p.75 / Chapter Chapter 2 --- My Contributions to the Medical Treatment of Uncomplicated Peptic Ulcer --- p.78 / Chapter Chapter 3 --- Review on Current Treatment of Perforated Peptic Ulcer --- p.79 / Chapter 3.1 --- Introduction --- p.79 / Chapter 3.2 --- Currently Available Treatment Options --- p.80 / Chapter 3.2.1 --- Perforated Duodenal Ulcer --- p.81 / Chapter [A] --- Nonoperative Treatment --- p.81 / Chapter [B] --- Laparotomy and patch repair --- p.83 / Chapter [C] --- Definitive Ulcer Surgery --- p.84 / Chapter [D] --- Laparoscopic Treatment --- p.87 / Chapter 3.2.2 --- Perforated Gastric Ulcer --- p.89 / Chapter PART IV --- DEVELOPMENT OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER IN OUR CENTRE --- p.91 / Chapter Chapter 1 --- Development of the Technique of Laparoscopic Suture Repair of Perforated Peptic Ulcer --- p.92 / Chapter 1.1 --- Surgical Technique --- p.93 / Chapter 1.2 --- Initial Results of Laparoscopic Suture Repair --- p.95 / Chapter Chapter 2 --- Development of the Technique of Laparoscopic Sutureless Repair of Perforated Peptic Ulcer --- p.98 / Chapter 2.1 --- Animal Studies --- p.98 / Chapter [A] --- Pilot Animal Study --- p.99 / Chapter [B] --- Mortality Rate on Different Methods of Repair of the Perforations --- p.100 / Chapter [C] --- Strength of the Repair Site by Studying the Bursting Pressure --- p.103 / Chapter [D] --- Detailed Histological Study --- p.108 / Chapter 2.2 --- Clinical Studies --- p.111 / Chapter [A] --- Surgical technique of Laparoscopic Sutureless Repair --- p.113 / Chapter [B] --- Initial Results of Laparoscopic Sutureless Repair --- p.114 / Chapter PART V --- TESTING THE HYPOTHESES OF THIS THESIS --- p.117 / Chapter Chapter 1 --- A Non-randomised Clinical Study --- p.119 / Chapter Chapter 2 --- A Randomised Clinical Study --- p.126 / Chapter PART VI --- CONCLUSIONS --- p.140 / Chapter PART VII --- THE FUTURE OF LAPAROSCOPIC REPAIR OF PERFORATED PEPTIC ULCER --- p.142 / Chapter PART VIII --- REFERENCES --- p.145 / References to the Precis --- p.146 / References to Part I Chapter 1 --- p.147 / References to Part I Chapter2 --- p.157 / References to Part II --- p.162 / References to Part III --- p.168 / References to Part IV --- p.183 / References to Part V --- p.186 / References to Part VII --- p.189 / APPENDIX I BRIEF SUMMARY OF MY CONTRIBUTIONS TO THE MEDICAL TREATMENT OF UNCOMPLICATED PEPTIC ULCER --- p.190