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Related Concept Videos

Endoscopic Procedures I: Esophagogastroduodenoscopy01:29

Endoscopic Procedures I: Esophagogastroduodenoscopy

An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
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Utilizing a 3D Printed Laparoscopic Nissen Fundoplication Model to Shorten a Resident's Learning Curve
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Experience with a training program for transgastric procedures in NOTES.

Karl-Hermann Fuchs1, Wolfram Breithaupt, Hans-Jürgen Kühl

  • 1Klinik für Viszeral-, Gefäss und Thoraxchirurgie, Markus-Krankenhaus, Frankfurter Diakonie Kliniken, Wilhelm Epstein-Str 4, 60431 Frankfurt am Main, Germany. Karl-Hermann.Fuchs@FDK.info

Surgical Endoscopy
|August 19, 2009
PubMed
Summary
This summary is machine-generated.

This study demonstrates a learning curve for transgastric endoscopic surgery (NOTES) procedures in a porcine model. Experienced surgeons and gastroenterologists can develop these techniques for clinical use, overcoming technical challenges.

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Area of Science:

  • Minimally Invasive Surgery
  • Gastroenterology
  • Surgical Training

Background:

  • Natural orifice transluminal endoscopic surgery (NOTES) utilizes transgastric approaches for abdominal procedures.
  • This study focused on training techniques and instrument applicability for transgastric procedures.

Purpose of the Study:

  • To evaluate the learning process during the establishment of a training program for NOTES.
  • Assess the applicability of instruments and techniques for both gastroenterologists and surgeons.

Main Methods:

  • A defined training program was conducted in a porcine model (n=10 sessions).
  • Procedures included transgastric tube resection (TTR), cholecystectomy (TCE), cardiomyotomy (TMY), and small bowel segmental resection (TSBR).
  • Evaluation focused on handling, access, closure, technical issues, and procedure duration to assess the learning curve.

Main Results:

  • Key technical challenges included intra-esophageal friction, platform instability, tissue retraction precision, and endoscopic vision independence.
  • Operative times varied: TTR (25-85 min), TCE (75-185 min), TMY (95-220 min), TSBR (100-260 min), indicating a learning curve.

Conclusions:

  • A learning curve was evident for all investigated transgastric techniques.
  • Results suggest feasibility for clinical application by experienced surgeons and gastroenterologists.
  • Technical limitations were more significant than educational background, emphasizing the need for flexible endoscopy, laparoscopy experience, and teamwork.