Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model (with video)

Pai, Reina D.; Fong, Derek G.; Bundga, Michele E.; Odze, Robert D.; Rattner, David W.; Thompson, Christopher C.

doi:10.1016/j.gie.2006.06.079

Cited by 307 publications

(202 citation statements)

References 10 publications

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“…The views of the upper abdominal organs, such as the liver and the gallbladder, are limited; these organs require retroflexion for the endoscope, as opposed to views of pelvic organs that are in the direct line of vision of a transgastric endoscope. 18 The optimal site of the gastrotomy to provide safe entry has to be elucidated. Reliable endoscopic gastric closure technique must be developed and improved.…”

Section: Commentmentioning

confidence: 99%

Pure NOTES Transvesical Venous Ligation: Translational Animal Model of Varicocelectomy

Osório

Schwartz

Autorino

et al. 2011

Urology

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OBJECTIVETo assess the feasibility of pure natural orifice transluminal endoscopic surgery (NOTES) transvesical venous ligation mimicking bilateral varicocelectomy in an animal model. MATERIALS AND METHODSTransvesical NOTES bilateral venous ligation was performed in 6 female pigs by considering lower epigastric vessels as a model for gonadal vessels. Under flexible cystoscopic guidance, a cystotomy was created on the anterior bladder. The flexible cystoscope was introduced through the over tube, and the lower epigastric vessels were visualized in retroflexion. Thulium laser was used to cut and coagulate the vessels. A bladder catheter was left in place for 4 days in all animals and they were sacrificed 15 days after the procedure. RESULTSThe procedure was successfully carried out in all animals without intraoperative complications. Epigastric vessels were safely cut and coagulated using the thulium laser. Median time for the overall procedure, including establishment of the transvesical port, was 23 minutes (range 20-30). No complications were encountered during the postoperative follow-up period. Postmortem examination revealed complete coagulation and separation of vessels. CONCLUSIONAn animal model mimicking a NOTES transvesical bilateral varicocelectomy procedure is successfully shown in the present study. Despite being encouraging, these novel findings need to be interpreted with caution. Further research is warranted and development of purpose-built instrumentation is awaited to define potential urological applications of transvesical NOTES. UROLOGY 78: 1082-1088, 2011. © 2011 V aricocele represents the most common correctable etiology found in adult men with infertility.

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Section: Commentmentioning

confidence: 99%

Pure NOTES Transvesical Venous Ligation: Translational Animal Model of Varicocelectomy

Osório

Schwartz

Autorino

et al. 2011

Urology

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“…In fact, Reddy and Rao (N. Reddy, V. G. Rao, oral communications, May 15 and 19, 2005; N. Reddy, oral communication, May 2004) and Kalloo et al [8] described a new port to the peritoneal cavity through a transgastric approach in humans and pigs, respectively. Subsequently, various authors described more-complex intra-abdominal procedures in porcine models, opening a new era in surgery that is being considered third generation surgery: the natural orifice translumenal endoscopic surgery (NOTES) [7,9,[11][12][13][14][19][20]. Building on these findings, our group described transvesical endoscopic peritoneoscopy as a complementary and safe approach to the abdominal cavity in a porcine model [10,16].…”

Section: Introductionmentioning

confidence: 99%

Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

et al. 2007

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Background: Recently there has been an increasing enthusiasm for using natural orifices translumenal endoscopic surgery (NOTES) to perform scarless abdominal procedures. We have previously reported the feasibility and safety of the transvesical endoscopic peritoneoscopy in a long-term survival porcine model as useful for those purposes. Herein, we report our successful experience performing transvesical and transdiaphragmatic endoscopic approach to the thoracic cavity in a long-term survival study in a porcine model. Methods: Transvesical and transdiaphragmatic endoscopic thoracoscopy was performed in six anesthetized female pigs. A 5 mm transvesical port was created on the bladder wall and an ureteroscope was advanced into the peritoneal cavity. After diaphragm inspection, we introduced through the left diaphragmatic dome a ureteroscope into the left thoracic cavity. In all animals, we performed thoracoscopy as well as peripheral lung biopsy. Animals were sacrificed by day 15 postoperatively. Results: We easily introduced a 9.8 Fr ureteroscope into the thoracic cavity that allowed us to visualize the pleural cavity and to perform simple surgical procedures such as lung biopsies without complications. There were neither respiratory distress episodes nor surgical complications to report. Postmortem examination revealed complete healing of vesical and diaphragmatic holes, whereas no signs of infection or adhesions were observed in the peritoneal or thoracic cavities. Conclusion: This study demonstrates the feasibility of transvesical thoracoscopy in porcine model. However, although this study extends the potential applications of NOTES to the thoracic cavity, new instruments and further work are needed to provide evidence that this could be translated to humans and with advantages for patients.

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“…NOTES techniques are in evolution; investigators from all over the world are working on NOTES procedures [1,2]. We agree that nomenclature is important in communicating about these techniques and believe that if dissection is primarily performed with laparoscopic instruments, then the procedure is laparoscopy.…”

mentioning

confidence: 99%

“…

After working in the animal lab, we acquired the necessary skills and experience to translate our work into human NOTES surgery [3].

We are happy that more groups are embracing this interesting technique and we encourage work such as yours in the animal lab before proceeding to the human operating room.

…”

mentioning

confidence: 99%

Reply to: 464_126 (2008: 22(12) 2763–2764) Re: Transvaginal laparoscopic cholecystectomy

et al. 2009

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We thank Dr. Alessiani for his comments and congratulate him for the excellent work done on NOTES in the animal lab.NOTES techniques are in evolution; investigators from all over the world are working on NOTES procedures [1,2]. We agree that nomenclature is important in communicating about these techniques and believe that if dissection is primarily performed with laparoscopic instruments, then the procedure is laparoscopy.After working in the animal lab, we acquired the necessary skills and experience to translate our work into human NOTES surgery [3].We are happy that more groups are embracing this interesting technique and we encourage work such as yours in the animal lab before proceeding to the human operating room. Transvaginal laparoscopically-assisted, endoscopic cholecystectomy: a hybrid approach to natural orifice surgery. Gastrointest Endosc 66(6):1243-1245

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Transcolonic endoscopic cholecystectomy: a NOTES survival study in a porcine model (with video)

Cited by 307 publications

References 10 publications

Pure NOTES Transvesical Venous Ligation: Translational Animal Model of Varicocelectomy

Pure NOTES Transvesical Venous Ligation: Translational Animal Model of Varicocelectomy

Transvesical thoracoscopy: A natural orifice translumenal endoscopic approach for thoracic surgery

Reply to: 464_126 (2008: 22(12) 2763–2764) Re: Transvaginal laparoscopic cholecystectomy

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