The EURO-NOTES clinical registry for natural orifice transluminal endoscopic surgery: a 2-year activity report

Arezzo, Alberto; Zornig, C.; Mofid, Hamid; Fuchs, Karl–Hermann; Breithaupt, Wolfram; Noguera, José; Kaehler, Georg; Magdeburg, Richard; Perretta, Silvana; Dallemagne, Bernard; Marescaux, Jacques; Copăescu, C; Graur, Florin; Szasz, A; Forgione, Antonello; Pugliese, Raffaele; Bueß, G.; Bhattacharjee, Hemanga K.; Navarra, Giuseppe; Godina, Mario; Shishin, K; Morino, Mario

doi:10.1007/s00464-013-2908-5

Cited by 61 publications

(47 citation statements)

References 33 publications

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“…Owing to this, natural orifice specimen extraction (NOSE) was introduced as a method of removing bulky specimens without elongating port sites. While NOSE has been frequently applied to colon resections for benign indications [88,89], there have been few reports of transanal and transvaginal NOSE for colorectal cancer [90][91][92]. One study by Park et al (n = 68) compared laparoscopic right hemicolectomy with transvaginal NOSE versus laparoscopically assisted right hemicolectomy for colon cancer, finding decreased postoperative pain and LOS, although, postoperative morbidity was not statistically significantly decreased [93] and wound infection rates with NOSE [94].…”

Section: • • Laparoscopic Techniques and Natural Orifice Specimen Extramentioning

confidence: 94%

Future directions in surgery for colorectal cancer: the evolving role of transanal endoscopic surgery

2014

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The current standard of care for resectable rectal cancers is total mesorectal excision (TME), which is usually performed open or laparoscopically, however, both techniques are associated with high morbidity and mortality.• Transanal endoscopic surgery (TES) is appropriate for benign rectal lesions and low-risk T1 tumors (Sm1; well differentiated; no lymphovascular or perineural invasion, and no tumor budding; <3 cm in size; <30% bowel circumference; and anticipated 3-mm clear margin).• Promising data support the use of neoadjuvant chemoradiation in making more lesions amenable to TES.• TES could potentially become favored over more radical surgery for preoperatively staged T2 tumors after neoadjuvant treatment.• Criteria for 'watch-and-wait' approaches are in flux because TES may have a role as a macrobiopsy for determining postneoadjuvant therapy T-stage, since long-term oncologic outcomes for TES are more related to ypT-stage rather than pretreatment T-stage.• Increasing data support transanal natural orifice translumenal endoscopic surgery (NOTES) TME as an acceptable alternative to open and laparoscopic TME, with regards to oncologic and functional outcomes.• Treatment paradigms including transanal NOTES to perform sentinel-node biopsies may provide more accurate staging, and potentially eliminate the need for TME in some cases.• Transanal NOTES TME should only be performed in carefully selected patients by surgeons with extensive experience with TES, laparoscopic TME and intersphincteric resection.SUMMARY The morbidity associated with radical surgery for rectal cancer has launched a revolution in increasingly less-invasive methods of resection, including a recent resurgence in transanal endoscopic surgical approaches. The next evolution in transanal surgery for rectal cancer is natural orifice translumenal endoscopic surgery (NOTES). To date, 14 series of transanal NOTES total mesorectal excision (TME) for rectal cancer have been published (n = 76).For reprint orders, please contact: reprints@futuremedicine.com

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Section: • • Laparoscopic Techniques and Natural Orifice Specimen Extramentioning

confidence: 94%

Future directions in surgery for colorectal cancer: the evolving role of transanal endoscopic surgery

2014

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“…The International Multicenter Trial on NOTES (IMTN) 24 and the German Registry D-NOTES 25 reported good clinical results of TV NOTES. In the IMTN Study, the complication rate was 6.9 %.…”

Section: Transgastric Route In Gastrointestinal Surgery (Dr Hungness)mentioning

confidence: 95%

“…Arezzo et al described 33 NOTES appendectomies, 86 % of which performed with a TG hybrid approach. 24 Gastric closure with a commercially available clip resulted in a 96 % closure rate. The only failure required laparoscopic suturing to close the gastrotomy.…”

Section: Transgastric Route In Gastrointestinal Surgery (Dr Hungness)mentioning

confidence: 99%

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Emerging Techniques in Minimally Invasive Surgery. Pros and Cons

Fisichella

DeMeester

Hungness³

et al. 2015

Journal of Gastrointestinal Surgery

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New trends have emerged regarding the best minimally invasive access approaches to perform gastrointestinal surgery. However, these newer approaches are seen critically by those who demand a more strict assessment of outcomes and safety. An international panel of expert gathered at the 2014 American College of Surgeons Meeting with the goal of providing an evidence-based understanding of the real value of these approaches in gastrointestinal surgery. The panel has compared the efficacy and safety of most established approaches to gastrointestinal diseases to those of new treatment modalities: peroral esophageal myotomy vs. laparoscopic myotomy for achalasia, transgastric vs. transvaginal approach, and single-incision vs. multi-port access minimally invasive surgery. The panel found that (1) the outcome of these new approaches was not superior to that of established surgical procedures; (2) the new approaches are generally performed in few highly specialized centers; and (3) transgastric and transvaginal approaches might be safe and feasible in very experienced hands, but cost, training, operative time, and tools seem to limit their application for the treatment of common procedures such as cholecystectomy and appendectomy. Because the expected advantages of new approaches have yet to be proven in controlled trials, new approaches should be considered for adoption into practice only after thorough analyses of their efficacy and effectiveness and appropriate training.

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“…Despite the momentum the NOTES technique has gathered, the unavailability of specialized equipments and dedicated platforms have hampered the widespread clinical adoption of NOTES[10]. However, the NOTES procedure is continually evolving with initially-envisioned procedures such as cholecystectomy and appendectomy now giving way to a variety of newer techniques such as peroral endoscopic myotomy (POEM) [11], endoscopic submucosal dissection (ESD) [12], [13], transanal rectal resection [14] and endoscopic full thickness resection [15].…”

Section: Introductionmentioning

confidence: 99%

Characterization of Force and Torque Interactions During a Simulated Transgastric Appendectomy Procedure

Dargar¹,

Brino

Matthes

et al. 2015

IEEE Trans. Biomed. Eng.

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We have developed an instrumented endoscope grip handle equipped with a 6-axis load cell and measured forces and torques during a simulated transgastric NOTES appendectomy procedure performed in an EASIE-R© ex vivo simulator. The data were collected from 10 participating surgeons of varying degrees of expertise which was analyzed to compute a set of 6 force and torque parameters for each coordinate axis for each of the nine tasks of the appendectomy procedure. The mean push/pull force was found to be 3.64 N (σ=3.54 N) in the push direction and the mean torque was 3.3 N-mm (σ=38.6 N-mm) in the counter-clockwise direction about the push/pull axis. Most interestingly, the force and torque data about the non-dominant×and z axes showed a statistically significant difference (p<0.05) between the expert and novice groups for five of the nine tasks. This data may be useful in developing surgical platforms especially new haptic devices and simulation systems for emerging natural orifice procedures.

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The EURO-NOTES clinical registry for natural orifice transluminal endoscopic surgery: a 2-year activity report

Cited by 61 publications

References 33 publications

Future directions in surgery for colorectal cancer: the evolving role of transanal endoscopic surgery

Future directions in surgery for colorectal cancer: the evolving role of transanal endoscopic surgery

Emerging Techniques in Minimally Invasive Surgery. Pros and Cons

Characterization of Force and Torque Interactions During a Simulated Transgastric Appendectomy Procedure

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