Comparative study of NOTES alone vs. EUS-guided NOTES procedures

Abstract

EUS guidance appears to be helpful in gaining access or identifying structures in anatomically difficult areas in NOTES procedures.

Transvaginal natural orifice transluminal endoscopic surgery (NOTES)-assisted laparoscopic adrenalectomy: first clinical experience

“…During the past few years, many clinical studies of LESS and animal experiments with NOTES for adrenalectomy have been conducted in many centers, leading to some inspiring results [12][13][14][15]. To our knowledge, these are the first reports of clinical research investigating TNLA.…”

Pure natural orifice transluminal endoscopic surgery (NOTES) with ultrasonography-guided transgastric access and over-the-scope-clip closure: a porcine feasibility and survival study

“…One study reported a complication rate of 15.5% for gastrotomy creation with a needleknife and balloon dilation, concluding that gastric punctures should be made with laparoscopic visualization or with a percutaneous endoscopic gastrotomy (PEG)-like approach using noncutting devices [35]. The use of EUS [31,32] and the application of hydroperitoneum [36] have been evaluated in terms of reducing the risk of access-related complications. In the latter study, no complications were recorded when hydroperitoneum was established via percutaneous instillation of 3 l sterile saline through a Veress needle before TG access.…”

“…It is speculated that with the help of endoscopic ultrasonography (EUS), TG pure-NOTES access could be achieved without laparoscopic assistance and also without the risk of access-related complications [31,32].…”

Natural orifice translumenal endoscopic surgery (NOTES®): a technical review

“…Most procedures to date have thus utilized a hybrid transgastric approach with laparoscopic guidance. There have been several proposed techniques to perform blind transgastric access that involve using endoscopic ultrasound or invaginating the gastric wall to distract the stomach away from surrounding organs [65,73,74]. These have been attempted in animal studies but have not yet been reported in the human literature.…”