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Pure NOTES sigmoid resection in an animal survival model
J Bernhardt1, P Köhler, F Rieber
1Department of Diagnostic and Interventional Endoscopy, Klinikum Suedstadt Rostock, Suedring 81, Rostock, Germany. joern.bernhardt@kliniksued-rostock.de
Endoscopy
|February 23, 2012
Summary
This study demonstrates a novel pure natural orifice transluminal endoscopic surgery (NOTES) technique for sigmoid resection in pigs. The combined transgastric and transvaginal approach proved feasible and effective for large bowel surgery.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Innovation
Background:
- Single-site transluminal access for major surgery remains challenging.
- Natural orifice transluminal endoscopic surgery (NOTES) offers a less invasive alternative.
- Developing pure NOTES techniques is crucial for advancing endoscopic surgery.
Purpose of the Study:
- To develop and evaluate a pure NOTES technique for sigmoid resection.
- To assess the feasibility of combined transgastric and transvaginal access.
- To utilize colonoscopy for enhanced organ manipulation and exposure.
Main Methods:
- A porcine model was used for the experimental study.
- Transgastric and transvaginal access were established for sigmoid resection.
- Colonoscopy, gastroscopic dissection, and transvaginal stapling were employed.
Main Results:
- The pure NOTES sigmoid resection was successful in all animals.
- Complete anastomotic healing and gastric closure were observed.
- Operation times ranged from 150 to 270 minutes.
Conclusions:
- Pure NOTES resection and anastomosis of the large bowel are feasible.
- Intraluminal organ manipulation enhances exposition and reduces access needs.
- Transgastric preparation is a safe and effective component of this NOTES technique.
