Durability of the self-approximating translumenal access technique (STAT) for potential use in natural orifice translumenal surgery (NOTES)

Abstract

Although this study was a limited, prospective, animal survival study without a control arm, it again indicates that STAT allows safe abdominal access, a reliable means of closure, and directed endoscope positioning. Although one significant mucosal tear did occur, this study suggests STAT will tolerate the mechanical forces of peroral transgastric procedures provided the organ resected is small to moderate in size (<8 × 3 cm).

Reliability of gastric access closure with the self-approximating transluminal access technique (STAT) for NOTES

“…• Protocol 3 Organ resection and specimen extraction ( Fig. 2): organ resection (gallbladder or uterine horn) and extraction of resected and standard specimens (2 cm CRE balloon and an 8 9 3-cm rigid object) were performed in 14 swine, demonstrating the feasibility of laparoscopically unassisted, pure NOTES procedures and the durability of the submucosal tunnel [16]. • Protocol 4 Acellular matrix implantation: benefits of a prototype tissue matrix on tissue closure deployed at the serotomy site were evaluated in five adult swine after organ resection (unpublished).…”

Natural Orifice Transesophageal Endoscopic Surgery: State of the Art

“…On the other hand, Moyer et al tested durability of submucosal endoscopic tunnel in the stomach and concluded that it tolerates the mechanical forces of peroral transgastric procedures provided that the organ resected is small to moderate in size (<8 × 3 cm) [23]. …”

The Rise of Tunnel Endoscopic Surgery: A Case Report and Literature Review

“…While in STAT, a fluid cushion of normal saline was made, and submucosal tunnel was created by the sharp and blunt dissection of a grasping forcep and the leading edge of the endoscopy itself [1]. The evidence to date suggests that STAT allows safe and reliable translumenal access and the removal of small-to-moderate-sized (<8 × 3 cm) specimens during NOTES  procedures in animal models [14]. A comparative study of four different transgastric access showed that an extended submucosal tunnel yielded the best leak resistance, which is superior to standard transgastric access methods and rival handsewn interrupted stitches [15].…”