Safe sigmoid access for natural orifice transluminal endoscopic surgery (NOTES)

Area of Science:

• Surgical Innovation
• Minimally Invasive Surgery
• Transanal Endoscopic Microsurgery

Background:

• Transluminal surgery faces challenges with sterile and safe access.
• Transanal approaches are ideal but deemed too risky due to contamination and leakage concerns.

Purpose of the Study:

• To develop and evaluate a new, safe, and sterile transanal access technique for transluminal surgery.

Main Methods:

• The technique integrates four principles: decontaminating hydroperitoneum, an overtube, ultrasound-guided entry point definition, and a dedicated closure method.
• Initial validation was conducted through extensive animal experiments.
• Feasibility was subsequently demonstrated in human cadavers.

Main Results:

• The developed transanal access method proved to be applicable and reliable in animal models.
• Human cadaver studies confirmed the feasibility of this novel access technique.

Conclusions:

• This innovative transanal access technique offers a safe and sterile solution for transluminal surgery.
• The findings support the potential of this method to overcome previous limitations associated with transanal approaches.