Techniques for transgastric access to the peritoneal cavity

Area of Science:

• Minimally invasive surgical techniques
• Gastroenterology and surgical innovation
• Endoscopic surgery

Background:

• Natural orifice translumenal endoscopic surgery (NOTES) represents an emerging surgical paradigm.
• NOTES aims to reduce surgical trauma by eliminating external incisions.
• Current NOTES procedures often adapt laparoscopic techniques.

Purpose of the Study:

• To review and describe transgastric access techniques for the peritoneal cavity in NOTES.
• To highlight methods used in published animal studies of NOTES.
• To evaluate the potential of NOTES in minimizing surgical access trauma.

Main Methods:

• Review of published animal studies detailing NOTES procedures.
• Focus on techniques for accessing the peritoneal cavity via a transgastric route.
• Description of percutaneous endoscopic gastrostomy-style gastrotomy for access.

Main Results:

• Various transgastric access techniques have been employed in animal models for NOTES.
• The peroral transgastric route is favored due to potentially lower risks of organ injury.
• Anterior wall gastrotomy is a common approach for peritoneal access.

Conclusions:

• Transgastric access is a key technique in developing NOTES procedures.
• Minimizing trauma through incisionless surgery is a primary goal of NOTES.
• Further research in animal models informs the advancement of NOTES techniques.