Gastric emptying is delayed in transgastric NOTES: a randomized study in swine

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Surgical Endoscopy

Background:

• Natural Orifice Transluminal Endoscopic Surgery (NOTES) offers a less invasive surgical approach.
• Evaluating gastrointestinal (GI) motility restoration post-NOTES is crucial for patient recovery.
• Capsule endoscopy (CE) is a tool for assessing GI transit and function.

Purpose of the Study:

• To assess gastrointestinal motility restoration following different NOTES procedures.
• To compare the impact of transgastric (gNOTES), transrectal (rNOTES), and transvaginal (vNOTES) NOTES, alongside laparoscopy (LAP), on GI function.
• To determine if surgical approach influences post-operative weight gain and gastric emptying.

Main Methods:

• Twenty Yorkshire pigs underwent gNOTES, rNOTES, vNOTES, or LAP procedures.
• A 30-minute peritoneoscopy was performed, followed by CE placement into the gastric antrum.
• Animals were observed for 14 days to evaluate CE passage and weight changes.

Main Results:

• Transgastric NOTES (gNOTES) procedures had longer surgery and closure times.
• CE retention in the stomach was highest in the gNOTES group, indicating delayed gastric emptying.
• Animals in the gNOTES group exhibited significantly less weight gain compared to vNOTES and other groups.

Conclusions:

• Gastric emptying is significantly delayed after gNOTES peritoneoscopy compared to rNOTES, vNOTES, and LAP.
• The delayed gastric emptying following gNOTES is associated with reduced post-operative weight gain.
• CE is effective in evaluating GI motility disturbances after NOTES procedures.