Peroral transgastric endoscopic procedures in pigs: feasibility, survival, questionings, and pitfalls

Abstract

This study reports the feasibility of natural orifice transluminal endoscopic surgery (NOTES) procedures in a porcine survival model and impresses the efficacy, the safety, the complications, and some technical difficulties of transgastric NOTES procedures, which merit further evaluation in future studies.

Natural orifice translumenal endoscopic surgery: critical appraisal of applications in clinical practice

“…It is important to emphasise that all human studies need to be conducted with local independent review board (IRB) approval [28] to avoid unnecessary trials and some of the scepticism seen during the introduction of laparoscopic surgery. Although the published data on humans to date have shown favorable results, animal studies have shown serious intraoperative difficulties with the use of current technologies as well as postoperative complications of gastric closure such as peritonitis [29]. This also is highlighted by the operative difficulties and complications of transumbilical flexible endoscopic cholecystectomy reported by Palanivelu et al [27].…”

A review of 130 humans enrolled in transgastric NOTES protocols at a single institution

“…The ability to completely explore the abdomen has been confirmed in many animal investigations [1,35]. To date, however, there are few reports of a translumenal diagnostic exploration in a human model.…”

“…Blind access to the stomach was first described almost 30 years ago with Gauderer's account of the percutaneous endoscopic gastrostomy (PEG) tube [31]. To date, this approach has been reported in many different operations, including hernia repairs, bowel anastomoses, and solid organ removal [11,22,26,[32][33][34][35][36]. Additionally, the muscular stomach wall will easily tolerate the shearing forces associated with intra-abdominal endoscopic manipulation.…”

Transumbilical single-incision laparoscopic inguinal hernia repair – feasibility study on anatomical specimens

“…With this technique it is assumed that less postoperative pain, faster recovery and reduced abdominal scarring can be achieved [1]. For this, organs such as the vagina [2][3][4], the colon [5] or the stomach [6,7] are penetrated.…”