[The first NOTE (Natural Orifice Translumenal Endoscopic) cholecystectomy in Romania: an experimental model in pig]

NOTES (Natural Orifice Translumenal Endoscopic Surgery) represents a very new acquisition in the field of gastrointestinal endoscopy, which uses common flexible endoscopes in order to perform intraperitoneal surgical procedures. This procedure offers a very good visualisation of the peritoneal cavity, as well as the possibility of performing surgical procedures. The aim of the study is to report our experience--the first of its kind in Romania--in performing per os, transgastric procedures, emphasizing the technical challenges and the possible complications associated with this method. This is an experimental study, using pigs (tri-hybrid PIC strain), in which peritoneoscopy and cholecystectomy were performed via a hybrid-NOTES approach (a 5 mm laparoscopic port has been used, placed in the right upper quadrant). The transgastric approach of the peritoneal cavity proved to be easy, allowing simple surgical procedures. The results of the study show the feasibility of the method. During surgery, no serious complications occurred, the minor incidents being managed without conversion to classical or laparoscopic surgery.