Natural Orifice Transesophageal Endoscopic Surgery: State of the Art

Moreira-Pinto, João; Ferreira, Aníbal; Rolanda, Carla; Correia‐Pinto, Jorge

doi:10.1155/2012/896952

Cited by 10 publications

(11 citation statements)

References 47 publications

(65 reference statements)

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“…Indeed, for the first time in history resection of abdominal organs could become incisionless, scarless, and nearly painless. Decreased postoperative pain, reduction/elimination of general anesthesia, improved cosmetic outcomes, elimination of skin incision‐related complications such as wound infections and hernias, and increased overall patient satisfaction …”

Section: Natural Orifice Transluminal Endoscopic Surgerymentioning

confidence: 99%

“…Nevetheless by means of a 10 cm submucosal tunnel, CO2 insuflation, and particularly employing new image registration systems (IRS), based on computed tomography or endosonography, exploration might be possible with quite acceptable morbidity . For more ambitious procedures such as pulmonary lobectomy or heart surgery, a mixed technique of transesophageal NOTES in association with single‐port thoracoscopy might represent an advantageous option …”

Section: Esophageal Accessmentioning

confidence: 99%

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Evolving endoscopic surgery

Sakai

Faintuch

2014

J of Gastro and Hepatol

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Since the days of Albukasim in medieval Spain, natural orifices have been regarded not only as a rather repugnant source of bodily odors, fluids and excreta, but also as a convenient invitation to explore and treat the inner passages of the organism. However, surgical ingenuity needed to be matched by appropriate tools and devices. Lack of technologically advanced instrumentation was a strong deterrent during almost a millennium until recent decades when a quantum jump materialized. Endoscopic surgery is currently a vibrant and growing subspecialty, which successfully handles millions of patients every year. Additional opportunities lie ahead which might benefit millions more, however, requiring even more sophisticated apparatuses, particularly in the field of robotics, artificial intelligence, and tissue repair (surgical suturing). This is a particularly exciting and worthwhile challenge, namely of larger and safer endoscopic interventions, followed by seamless and scarless recovery. In synthesis, the future is widely open for those who use together intelligence and creativity to develop new prototypes, new accessories and new techniques. Yet there are many challenges in the path of endoscopic surgery. In this new era of robotic endoscopy, one will likely need a virtual simulator to train and assess the performance of younger doctors. More evidence will be essential in multiple evolving fields, particularly to elucidate whether more ambitious and complex pathways, such as intrathoracic and intraperitoneal surgery via natural orifice transluminal endoscopic surgery (NOTES), are superior or not to conventional techniques.

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Section: Natural Orifice Transluminal Endoscopic Surgerymentioning

confidence: 99%

Section: Esophageal Accessmentioning

confidence: 99%

Evolving endoscopic surgery

Sakai

Faintuch

2014

J of Gastro and Hepatol

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“…Indeed, transesophageal mediastinoscopy in the porcine model has been occasionally complicated by tension pneumothorax [39], and hemodynamic and respiratory changes have also been documented [40]. Experimental models have included mediastinoscopy, thoracoscopy, mediastinal lymph node resection, pericardiac fenestration, left atrium injection, epicardial ablation, sympathectomy, vagotomy, esophagectomy, and pulmonary lobectomy [39,40,41,42,43,44,45,46]. Clinical experience is currently limited to endoscopic cardiomyotomy.…”

Section: Transesophageal Proceduresmentioning

confidence: 99%

NOTES: Current Status and Recent Developments

Antoniou

Bartsch

2012

Visc Med

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Background: The beneficial clinical results of laparoscopic surgery have prompted modern investigations to further minimize surgical trauma and to optimize cosmetic results. Natural orifice transluminal endoscopic surgery (NOTES®) refers to the surgical concept of entering the surgical field through a body lumen for diagnostic and therapeutic purposes without producing visible scars. Method: A review of the current literature was undertaken by means of the electronic databases Excerpta Medica and EMBASE. Results: Although the level of clinical evidence is low, the concept of NOTES has found clinical application in a variety of abdominal procedures, such as cholecystectomy, appendectomy, and sigmoidectomy. The vagina represents the most frequent access route for NOTES while the stomach, the rectum, and the transoral approach are further options. Several clinical studies have demonstrated the feasibility of a wide variety of NOTES procedures; however, there are currently no hard data supporting the superiority of this approach over conventional laparoscopic techniques. Furthermore, inherent limitations of the NOTES concept, such as the loss of triangulation, difficult tissue manipulation, and the potential contamination of the surgical field, warrant technological advances in medical endoscopy, instrumentation, and endoscopic tissue closure. Conclusions: In its current status, NOTES has to be considered as a stage towards minimization of surgical access trauma rather than as an established surgical concept.

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“…Pathologies and degenerative phenomena may affect the proper behaviour of gastrointestinal district as one of the most relevant social-health problems [3][4][5]. Many techniques have been provided for gastrointestinal tissues screening and surgery, aiming at the less invasive action [6][7][8][9][10][11][12]. The design of surgical procedures and devices, together with prosthetic elements and biomaterials, is correlated with the analysis of the tissues and organs functionality from a biomechanical view point [13].…”

Section: Introductionmentioning

confidence: 99%

Computational tools for the analysis of mechanical functionality of gastrointestinal structures

Carniel

Fontanella

Polese

et al. 2013

THC

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BACKGROUND AND OBJECTIVE: The gastrointestinal tract is a primary district of the living organism that shows a complex configuration in terms of biological tissues and structural conformation. The investigation of tissues mechanical functionality in healthy and degenerative conditions is mandatory to plan and design innovative diagnostic and surgical procedures. The aim of this work is to provide some tools for the mechanical analysis of gastrointestinal structures. METHODS: Computational methods allow for evaluating tissues behaviour and interaction phenomena between biomedical devices, prosthetic elements and tissues themselves. The approach envisages a strong integration of expertise from different areas, proceeding from medicine to bioengineering, computational and experimental biomechanics, bio-robotics and materials science. The development of computational models of gastrointestinal structures requires data from histological analysis and mechanical testing, together with engineering and mathematical skills for the definition of constitutive formulations and numerical procedures. RESULTS AND CONCLUSION: An outline of the computational mechanics approach to the investigation of the gastrointestinal tissues and structures response is reported. A general formulation is presented together with specific applications to oesophageal and colonic tissues. Preliminary results from the numerical analysis of interaction phenomena between colonoscopy devices and tissues are also proposed to address to aspects that allow for an evaluation of feasibility and reliability of the proposed approach.

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Natural Orifice Transesophageal Endoscopic Surgery: State of the Art

Cited by 10 publications

References 47 publications

Evolving endoscopic surgery

Evolving endoscopic surgery

NOTES: Current Status and Recent Developments

Computational tools for the analysis of mechanical functionality of gastrointestinal structures

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