Pure transgastric NOTES laparoscopy compared to classic laparoscopy
Authors:
V. Veselý; V. Třeška; J. Moláček; D. Šmíd
Authors place of work:
Chirurgická klinika LF UK a FN v Plzni, přednosta: prof. MUDr. Vladislav Třeška, DrSc.
Published in the journal:
Rozhl. Chir., 2012, roč. 91, č. 2, s. 77-80.
Category:
Original articles
Summary
Introduction:
NOTES – Natural Orifice Transluminal Endoscopic Surgery – represents a new surgical approach. The operation is performed via natural openings of the body without causing any damage to the skin and the abdominal wall. At the Department of Surgery of the University Hospital in Pilsen, we have been performing NOTES since 2008. The first animal experiment was performed in that year by a hybrid NOTES technique.
Methods:
A prospective study was carried out at the animal experimental room of Charles University in Prague, Faculty of Medicine in Pilsen, on domestic pigs under general anaesthesia. 15 pigs were operated on by the transgastric pure NOTES method using double-channel endoscope. Gastrotomy was performed using a needle knife and the stomach was closed by OTSC clips. The control group consisting of 15 pigs was operated on by classic laparoscopy through a 14-mm port with the use of double-channel endoscope. During the following two weeks the animals underwent clinical monitoring and sonographic examinations, and samples for biochemical and microbiological analysis were collected. Post-mortem examination focusing on infectious complications was performed after 14 days.
Results:
In comparison with the conventional laparoscopic technique, the transgastric pure NOTES approach has shown similar results. Inflammation in the skin suture appeared in 6 pigs operated on by classic laparascopy. During the clinical and sonography follow-up as well as in the autopsy of both groups, no signs of focal infection in the abdominal cavity were shown.
Conclusion:
The pure NOTES approach is very difficult, though not unfeasible to put into practice due to our present technical equipment. The development and implementation of the NOTES access into clinical practice would demand better technical equipment.
Key words:
NOTES – laparoscopy – animal experiment
Zdroje
1. Kalloo AN, Singh VK, Jagannath SB, et al. Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 2004;60 (1):114–117.
2. Fong DG, Pai RD, Thompson CC. Transcolonic endoscopic abdominal exploration: a NOTES survival study in a porcine model. Gastrointest Endosc 2007;65:312–8.
3. Fong DG, Ryou M, Pai RD, et al. Transcolonic ventral hernia mesh fixation in a porcine model. Endoscopy 2007;39:865–9.
4. Fritscher-Ravens A, Mosse CA, Ikeda K, et al. Endoscopic transgastric lymphadenectomy by using EUS for selection and guidance. Gastrointest Endosc 2006;63:302–6.
5. Jaganath SB, Kantesevoy SV, Vaughn CA, et al. Peroral transgastric endoscopic ligation of fallopian tubes with long-term survival in porcine model. Gastrointest Endosc 2005; 61:449–53.
6. Kantesevoy SV, Hu B, Jagannath SB, et al. Transgastric endoscopic splenectomy. Is it possible? Surg Endosc 2006;20:522–5.
7. Kantesevoy SV, Jaganath SB, Niiyama H, et. al. Endoscopic gastrojejunostomy with survival in a porcine model. Gastrointest Endosc 2005;62:287–92.
8. Lima E, Henriques-Cielho T, Rolanda C, et al. Transvesical thoracoscopy: a natural orifice transluminal endoscopic approach for thoracic surgery. Surg Endosc 2007;21:854–8.
9. Matthes K, Zusuf TE, Willingham FF, et al. Feasibility of endoscopic transgastsric distal pancreatectomy in the porcine animal model. Gastrointest Endosc 2007;66:762–6.
10. Pai RD, Fong DG, Bundga ME, et. al. Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model. Gastrointest Endosc 2007;64:428–34.
11. Park PO, Bergstrom M, Ikeda K, et al. Experimental studies of transgastric gallbladder surgery: Cholecystectomy and cholecystogastric anastomosis. Gastrointest Endosc 2005;61:601–6.
12. Wagh MS, Merrifield BF, Thompson CC. Survival studies after endoscopic transgastric oophorectomy and tubectomy in a porcine model. Gastrointest Endosc 2006;63:473–8.
13. Bessler M, Stevens PD, Milone L, Parikh M, Fowler D. Transvaginal laparoscopically assisted endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc 2007;66:1243–5.
14. Marescaux J, Dellemagne B, Perretta S, et al. Surgery without scars: report of transluminal cholecystectomy in a human being. Arch Surg 2007;142:823–6.
15. Zornig C, Emmermann A, Waldenfels HA, et. al. Laparoscopic cholecystectomy without visible scar: combined transvaginal and transumbilical approach. Endoscopy 2007;39:913–5.
Štítky
Surgery Orthopaedics Trauma surgeryČlánok vyšiel v časopise
Perspectives in Surgery
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