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Intraoperative NOTES endosonography and identification of mock hepatic lesions
Christopher J Fyock1, Tejas S Kirtane, Chris E Forsmark
1Division of Gastroenterology, University of Florida, Gainesville, FL 32610, USA.
Purpose:
Intraoperative ultrasound is commonly used during standard transabdominal surgery. The feasibility of endoscopic ultrasound (EUS) through Natural Orifice Translumenal Endoscopic Surgery (NOTES) for identification of abdominal lesions with a flexible echoendoscope has not been studied.
Aim:
To test the feasibility of NOTES-EUS for abdominal exploration and identification of mock hepatic lesions.
Methods:
Five pigs underwent transvaginal or transcolonic NOTES and endosonographic exploration. In 3 anesthetized pigs, mock hepatic lesions were created and NOTES-EUS was then performed to identify these mock lesions. Necropsy was performed in all cases.
Results:
All target organs were consistently identified by NOTES-EUS in all animals. Mock hepatic lesions were successfully created in 3 animals and were able to be located by NOTES-EUS. No complications were observed at necropsy.
Conclusions:
Abdominal exploration and localization of mock lesions by NOTES-EUS is technically feasible. As natural orifice surgery evolves, intraoperative NOTES-EUS would be an essential addition to the NOTES armamentarium.
