Rapid Communication: Transvaginal Single-Port NOTES Nephrectomy: Initial Laboratory Experience

Clayman, Ralph V.; Box, Geoffrey N.; Abraham, Jose Benito A.; Lee, Hak J.; Deane, Leslie A.; Sargent, Eric R.; Nguyen, Ninh T.; Chang, Kenneth J.; Tan, Amy K.; Ponsky, Lee; McDougall, Elspeth M.

doi:10.1089/end.2007.0145

Cited by 150 publications

(88 citation statements)

References 18 publications

(14 reference statements)

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“…Clayman et al reported transvaginal nephrectomy performed using a purpose-built multi-lumen operating platform [22]. Haber et al assessed the feasibility of pure NOTES transvaginal nephrectomy in a porcine model using NOTES-specific instrumentation without transabdominal ports [23].…”

Section: Clinical Application In Urologymentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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LESS Natural orifice transluminal endoscopic surgery NOTES Robotics UrologyPlease visit www.eu-acme.org/ europeanurology to read and answer questions on-line. The EU-ACME credits will then be attributed automatically. AbstractContext: Natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS) have been developed to benefit patients by enabling surgeons to perform scarless surgery. Objective: To summarize and critically analyze the available evidence on the current status and future perspectives of LESS and NOTES in urology. Evidence acquisition: A comprehensive electronic literature search was conducted in June 2010 using the Medline database to identify all publications relating to NOTES and LESS in urology. Evidence synthesis: In urology, NOTES has been completed experimentally via transgastric, transvaginal, transcolonic, and transvesical routes. Initial clinical experience has shown that NOTES urologic surgery using currently available instruments is indeed possible. Nevertheless, because of the immaturity of the instrumentation, early cases have demanded high technical virtuosity. LESS can safely and effectively be performed in a variety of urologic settings. As clinical experience increases, expanding indications are expected to be documented and the efficacy of the procedure to improve. So far, the quality of evidence of all available studies remains low, mostly being small case series or casecontrol studies from selected centers. Thus, the only objective benefit of LESS remains the improved cosmetic outcome. Prospective, randomized studies are largely awaited to determine which LESS procedures will be established and which are unlikely to stand the test of time. Technology advances hold promise to minimize the challenging technical nature of scarless surgery. In this respect, robotics is likely to drive a major paradigm shift in the development of LESS and NOTES. Conclusions: NOTES is still an investigational approach in urology. LESS has proven to be immediately applicable in the clinical field, being safe and feasible in the hands of experienced laparoscopic surgeons. Development of instrumentation and application of robotic technology are expected to define the actual role of these techniques in minimally invasive urologic surgery.

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Section: Clinical Application In Urologymentioning

confidence: 99%

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

et al. 2011

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“…Clayman et al reported transvaginal nephrectomy performed using a purpose-built operating platform (TransPort multi-lumen operating platform, USGI Medical, San Clemente, CA). 23 The porcine kidney was mobilized exclusively through the vaginal port, and the renal hilum was controlled with an endovascular stapler placed through a 12-mm umbilical port. This represented the initial report of a successful transvaginal porcine nephrectomy using purpose-built NOTES instrumentation.…”

Section: Nephrectomy (Table 2)mentioning

confidence: 99%

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

et al. 2010

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Objective of this study is to provide an evidence-based analysis of the current status and future perspectives of scarless urological surgery. A PubMed search has been performed for all relevant urological literature regarding natural orifice transluminal endoscopic surgery (NOTES) and laparoendoscopic single-site surgery (LESS). In addition, experience with LESS and NOTES at our own institution has been considered. All clinical and investigative reports for LESS and NOTES procedures in the urological literature have been considered. A wide variety of clinical procedures in urology have been succesfully completed by using LESS techniques. Thus far, experience with NOTES has largely been investigational, although early clinical reports are emerging. Further development of instrumentation and platforms is necessary for both techniques to become more widely adopted throughout the urological community.

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“…A completely transvaginal laparoscopic nephrectomy was performed once, but limitations imposed by porcine anatomy and available instrumentation hindered the procedure [22]. More recently, Clayman et al [32] performed a porcine nephrectomy with a single 12-mm trocar placed in the midline and the transvaginal introduction of a TransPort Multi-Lumen Operating Platform (USGI Medical, San Clemente, CA). This flexible device has four working channels and can be locked into position, creating a rigid multitasking platform that enables two-handed tissue manipulation [32].…”

Section: Applications In Urologymentioning

confidence: 99%

“…More recently, Clayman et al [32] performed a porcine nephrectomy with a single 12-mm trocar placed in the midline and the transvaginal introduction of a TransPort Multi-Lumen Operating Platform (USGI Medical, San Clemente, CA). This flexible device has four working channels and can be locked into position, creating a rigid multitasking platform that enables two-handed tissue manipulation [32]. Further, Lima et al [16] demonstrated the feasibility of NOTES nephrectomy.…”

Section: Applications In Urologymentioning

confidence: 99%

Transvesical endoscopic peritoneoscopy: Intra-abdominal scarless surgery for urologic applications

Lima¹,

Rolanda²,

Correia‐Pinto

2008

Curr Urol Rep

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For many abdominal procedures, advantages such as minimal scarring, reduced pain, and faster recovery have made laparoscopy the favored approach over traditional open surgery. The most recent minimally invasive approach is natural orifice transluminal endoscopic surgery (NOTES), which limits morbidity because this surgery does not require incision. This article reviews the history, development, and current and future applications of NOTES in the field of urology.

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Rapid Communication: Transvaginal Single-Port NOTES Nephrectomy: Initial Laboratory Experience

Abstract: Transvaginal NOTES nephrectomy can be accomplished in a porcine model. Additional testing on survival animals is necessary to validate this approach.

Cited by 150 publications

References 18 publications

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Laparoendoscopic Single-site and Natural Orifice Transluminal Endoscopic Surgery in Urology: A Critical Analysis of the Literature

Current status and future perspectives in laparoendoscopic single‐site and natural orifice transluminal endoscopic urological surgery

Transvesical endoscopic peritoneoscopy: Intra-abdominal scarless surgery for urologic applications

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