A Novel Method for Endoscopic Closure of Bladder Perforations During NOTES: Initial Experience from Animal Studies

Area of Science:

• Minimally Invasive Surgery
• Endoscopic Surgery
• Surgical Innovation

Background:

• Natural Orifice Translumenal Endoscopic Surgery (NOTES) presents challenges in accessing and closing internal organs.
• Effective closure of translumenal access sites, particularly bladder perforations, is crucial for patient safety and procedural success.

Purpose of the Study:

• To evaluate the feasibility and safety of a novel reserved thread technique for closing bladder perforations during NOTES.
• To assess the efficacy of this method in a live animal model.

Main Methods:

• The study utilized a live porcine model (n=5).
• A self-made trocar was inserted into the bladder, and the anterior bladder wall was punctured under ureteroscopic guidance.
• Reserved threads were placed and used to close the bladder perforation.

Main Results:

• The technique was successful in 4 out of 5 cases, with procedure times ranging from 25 to 45 minutes.
• Complete closure of bladder perforations was achieved in the successful cases.
• One initial failure was attributed to animal size.

Conclusions:

• The reserved thread method for closing bladder perforations during NOTES is safe and effective.
• This technique demonstrates significant clinical potential for NOTES procedures.
• Further large-scale survival studies are warranted to validate these findings.