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Related Experiment Video

Updated: Jun 16, 2026

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
09:04

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Published on: September 11, 2021

Safe alternative transgastric peritoneal access in humans: NOTES.

Peter Nau1, Joel Anderson, Lynn Happel

  • 1The Ohio State University Medical Center, Department of Surgery, Columbus, OH 43210-1228, USA. peter.nau@osumc.edu

Surgery
|February 4, 2010
PubMed
Summary
This summary is machine-generated.

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Transgastric endoscopic peritoneoscopy (TEP) safely accesses the abdomen for procedures like adhesiolysis and trocar placement without laparoscopic guidance. Gastric closure is the main limitation for wider clinical use.

Area of Science:

  • Minimally invasive surgery
  • Gastroenterology
  • Surgical innovation

Background:

  • Transgastric endoscopic peritoneoscopy (TEP) is an established diagnostic tool for abdominal evaluation.
  • This study explores TEP's utility beyond diagnostics, specifically for guiding trocar placement and performing adhesiolysis during laparoscopic Roux-en-Y gastric bypass.
  • The research addresses the challenge of accessing the peritoneum and performing procedures without traditional laparoscopic visualization.

Purpose of the Study:

  • To evaluate the safety and efficacy of transgastric endoscopic peritoneoscopy (TEP) for peritoneal access and intra-abdominal procedures.
  • To assess TEP's role in directing trocar placement and performing adhesiolysis in patients undergoing laparoscopic Roux-en-Y gastric bypass.
  • To compare TEP outcomes with and without pre-insufflation in patients with and without prior abdominal surgery.

Related Experiment Videos

Last Updated: Jun 16, 2026

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy
09:04

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Published on: September 11, 2021

Main Methods:

  • Forty patients undergoing laparoscopic Roux-en-Y gastric bypass were divided into two groups: pre-insufflation and no pre-insufflation.
  • Transgastric endoscopic peritoneoscopy (TEP) was performed through a gastrotomy without laparoscopic visualization.
  • Adhesions were visualized and lysed endoscopically prior to trocar placement; diagnostic findings and operative times were recorded.

Main Results:

  • Average TEP time was 19 minutes, with visualization limitations in three patients.
  • Adhesions were visualized in 3/20 patients without prior surgery and 17/20 with prior surgery, with endoscopic adhesiolysis performed in 1 and 4 patients, respectively.
  • Six occult umbilical hernias, one inguinal hernia, and one hiatal hernia were identified; no complications related to TEP were reported.

Conclusions:

  • Transgastric endoscopic peritoneoscopy (TEP) is a safe and accurate method for peritoneal access, visualization, and adhesiolysis, enabling guided trocar placement without laparoscopic assistance.
  • TEP facilitates visualization of abdominal structures and identification of hernias.
  • The primary limitation for broader clinical application of TEP is the need for secure and reliable gastric closure.