Comparison in efficacy between pure NOTES peritoneoscopy with small or large endoscope and laparoscopy.

Area of Science:

• Minimally Invasive Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Natural orifice transluminal endoscopic surgery (NOTES) offers a less invasive surgical approach.
• Transgastric peritoneoscopy is a specific NOTES technique requiring evaluation of different endoscope sizes.
• Comparison with traditional laparoscopy is crucial for assessing clinical utility.

Purpose of the Study:

• To compare the efficacy and systemic impact of small-sized (SS) versus large-sized (LS) endoscopes in pure transgastric NOTES peritoneoscopy.
• To evaluate the performance of transgastric NOTES peritoneoscopy against standard laparoscopy (SL).

Main Methods:

• Fifteen dogs were randomized into SS, LS, and SL groups.
• Procedure time, organ visualization, gastric incision healing, and complications were assessed.
• Systemic inflammatory markers (TNF-α, IL-6) and white blood cell counts were analyzed post-procedure.

Main Results:

• Peritoneoscopy was successful in all groups.
• Standard laparoscopy (SL) had significantly shorter procedure times than both LS and SS NOTES groups.
• No significant differences were found in visualization scores, inflammatory markers, or WBC counts among the groups.

Conclusions:

• Endoscope size does not confer a significant advantage in pure transgastric NOTES peritoneoscopy.
• Pure transgastric NOTES peritoneoscopy is comparable to laparoscopy in terms of invasiveness and procedure duration.