Laparoscopic sleeve gastrectomy with NOTES visualization—a step toward NOTES procedures

Marchesini, João Caetano; Cardoso, Almino Ramos; Nora, Mário; Neto, Manoel Galvão; Mottin, Cláudio Corá; Baretta, Giórgio Alfredo Pedroso; Padoin, Alexandre Vontobel; Moretto, Myriam; Maggioni, Lucas; Alves, Letícia Biscaino; Kupski, Carlos

doi:10.1016/j.soard.2008.08.026

Cited by 12 publications

(9 citation statements)

References 12 publications

(17 reference statements)

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“…In regard to animal studies, mean operative time described by Marchesini et al was 84 min [ 13 ], whilst Mintz et al obtained an operative time range of 150–300 min [ 15 ]. One postoperative complication (pneumonia) was reported—a rate of 3.8 %.…”

Section: Resultsmentioning

confidence: 99%

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Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures

2015

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This review aims to summarise clinical applications of natural orifice translumenal endoscopic surgery (NOTES) in bariatric surgery. A review of data, until December 2014, was carried out regarding techniques and outcomes of bariatric NOTES procedures. Nine publications were included in the final analysis, with another six papers describing endolumenal procedures included for comparison. All NOTES studies adopted a hybrid procedure. Hybrid NOTES sleeve gastrectomy (hNSG) was described in four humans and two porcine studies. In humans, six subjects (23.1 %) were converted to conventional laparoscopic methods, and one postoperative complication (3.8 %) was reported. Mean excess weight loss was 46.6 % (range 35.2–58.9). Transvaginal-assisted sleeve gastrectomy appears feasible and safe when performed by appropriately trained professionals. However, improvements must be made to overcome current technical limitations.

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Section: Resultsmentioning

confidence: 99%

“…Marchesini et al [ 13 ] used an umbilical port (12 mm) to maintain pneumoperitoneum, guidance of colpotomy, release of greater curvature using ultrasonic scalpel and gastric transection with an endolumenal stapler. Two portals (2 mm) were placed laterally for triangulation.…”

Section: Resultsmentioning

confidence: 99%

Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures

2015

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“…Of the possible accesses, the vagina has gained most popularity since it is readily accessible, is easy to decontaminate and provides safe entry and simple closure [15,16]. In the specific field of bariatric surgery, technical reports and limited case series describing sleeve gastrectomy have been published [5,[17][18][19][20] but with very few of these reporting medium-long-term results and the women's opinion about this technique [8,21]. The first cases of sleeve gastrectomy with hybrid access laparoscopic/trans-vaginal were published in 2008 by Marchesini et al [19].…”

Section: Discussionmentioning

confidence: 99%

“…In the specific field of bariatric surgery, technical reports and limited case series describing sleeve gastrectomy have been published [5,[17][18][19][20] but with very few of these reporting medium-long-term results and the women's opinion about this technique [8,21]. The first cases of sleeve gastrectomy with hybrid access laparoscopic/trans-vaginal were published in 2008 by Marchesini et al [19]. The authors concluded that sleeve gastrectomy should be performed in the traditional laparoscopic way, while the NOTES technique should be used to explore the abdominal cavity and the trans-vaginal access adopted as a collateral port to extract the operative specimen.…”

Section: Discussionmentioning

confidence: 99%

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

et al. 2011

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Much of the discussion pertaining to natural orifice transluminal endoscopic surgery (NOTES) focuses on technical issues, with little attention to women's perception and to their willingness to consent to this surgery, especially in the field of obesity. Aim of this study was to evaluate obese women's perception of NOTES and trans-vaginal access. Sixty two obese patients undergoing bariatric surgery were given a written description of NOTES with an anonymous questionnaire exploring their concerns and opinions regarding this technique. The risk of complications was the most important aspect with regard to surgical procedures for 87.1% of patients, while the aesthetic result counted only for 16.1%; none of the patients would accept an increased risk of surgical complications for a better aesthetic result, and 74.2% of them would prefer a standardized traditional surgical approach. Nulliparous women were more concerned about the potentially negative effects of NOTES on fertility than multiparous women and younger women were more worried about the effects on sexual function than older women. 83.9% of patients refusing NOTES stated that the main reason for their refusal was the lack of definitive data on the beneficial effects. Bariatric NOTES potentially offers obese women a scarless intervention, but only a few obese women expressed worries about the cosmetic/aesthetic effects of surgery, while most of them were worried about effects on future fertility and sexual life. Our study highlights a strong need for early reporting of outcome data to enlighten patients about this new approach to bariatric surgery.

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“…Les procédures NOTES (Natural Orifice Trans Endoscopic Surgery) représentent une des voies de recherche en phase de développement avancé grâce à un ancillaire spéci-fique, mais reposant aujourd'hui préférentiellement sur des techniques hybrides, où un abord coelioscopique est malgré tout nécessaire [10,11].…”

Section: Débat De La Voie D'abordunclassified

Malabsorption contre restriction en chirurgie de l’obésité: un débat dépassé ?

Dargent¹

2009

Obes

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De nombreux faits militent po*ur une abolition du rôle structurant de l'opposition restriction/malabsorption en chirurgie bariatrique : 1) des arguments techniques : certaines interventions ne rentrent pas formellement dans une classe ; une composante restrictive est une étape obligée ; 2) les arguments stratégiques : les stratégies par étapes font appel à une séquence optionnelle restriction, puis malabsorption ; le débat de la voie d'abord devient prééminent (voies non invasives) ; l'acceptabilité et la faisabilité de techniques de large diffusion ne penchent pas en faveur de la malabsorption à l'heure de la mondialisation de l'obé-sité. La reproductibilité de résultats tels que présentés par des promoteurs de la malabsorption peut être raisonnablement questionnée. C'est finalement l'argument du « gain de temps » qui doit l'emporter, privilégiant autant que possible une restriction simple et non invasive, accompagnée de mesures diététiques. Mots clés Obésité morbide · Chirurgie restrictive · Malabsorption · Chirurgie bariatriqueAbstract Several facts tell us that the difference between malabsorptive and restrictive surgeries is no longer relevant in bariatric surgery, which include technical and strategic points. Technical points: some procedures do not fit in the classification, and a restrictive component is mandatory in all operations. Strategic points: step-to-step procedures entail a sequence of restriction, followed by malabsorption; the debate over the surgical approach is predominant (noninvasive channels); acceptability and feasibility of widespread procedures are not in favor of malabsorption at times of "epidemic obesity." Besides, one may question the results that are supposedly obtained from malabsorptive surgery. Eventually, the argument of "time saving" must prevail: simple and non invasive restriction with diet counselling should be the best option for obese patients in the future.

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Laparoscopic sleeve gastrectomy with NOTES visualization—a step toward NOTES procedures

Cited by 12 publications

References 12 publications

Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures

Natural Orifice Translumenal Endoscopic Surgery: Review of Its Applications in Bariatric Procedures

Obese Women’s Perception of Bariatric Trans-vaginal NOTES

Malabsorption contre restriction en chirurgie de l’obésité: un débat dépassé ?

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